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Analysis of a National Programme for Selective Internal Radiation Therapy for Colorectal Cancer Liver Metastases
White, J Carolan-Rees, G Dale, M Morgan, HE Patrick, HE See, TC Beeton, EL Swinson, DEB Bell, Jon Manas, DM
White, J
Carolan-Rees, G
Dale, M
Morgan, HE
Patrick, HE
See, TC
Beeton, EL
Swinson, DEB
Bell, Jon
Manas, DM
Citations
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Abstract
AIMS:
Patients with chemotherapy-refractory colorectal cancer liver metastases have limited therapeutic options. Selective internal radiation therapy (SIRT) delivers yttrium 90 microspheres as a minimally invasive procedure. This prospective, single-arm, observational, service-evaluation study was part of National Health Service England Commissioning through Evaluation.
METHODS:
Patients eligible for treatment had histologically confirmed carcinoma with liver-only/liver-dominant metastases with clinical progression during or following oxaliplatin-based and irinotecan-based chemotherapy. All patients received SIRT plus standard of care. The primary outcome was overall survival; secondary outcomes included safety, progression-free survival (PFS) and liver-specific PFS (LPFS).
RESULTS:
Between December 2013 and March 2017, 399 patients were treated in 10 centres with a median follow-up of 14.3 months (95% confidence interval 9.2-19.4). The median overall survival was 7.6 months (95% confidence interval 6.9-8.3). The median PFS and LPFS were 3.0 months (95% confidence interval 2.8-3.1) and 3.7 months (95% confidence interval 3.2-4.3), respectively. During the follow-up period, 143 patients experienced an adverse event and 8% of the events were grade 3.
CONCLUSION:
Survival estimates from this pragmatic study show clinical outcomes attainable in the National Health Service comparable with previously published data. This study shows the value of a registry-based commissioning model to aid national commissioning decisions for highly specialist cancer treatments.
Description
Date
2018
Publisher
Collections
Keywords
Type
Article
Citation
White J, Carolan-Rees G, Dale M, Morgan HE, Patrick HE, See TC, et al. Analysis of a National Programme for Selective Internal Radiation Therapy for Colorectal Cancer Liver Metastases. Clinical Oncology. 2018 Oct.