Analysis of a National Programme for Selective Internal Radiation Therapy for Colorectal Cancer Liver Metastases
Slevin, Nicholas J
AffiliationCedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Cardiff, UK
MetadataShow full item record
AbstractAIMS: 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.
CitationWhite 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.
JournalClin Oncol (R Coll Radiol )
- Phase I trial of selective internal radiation therapy for chemorefractory colorectal cancer liver metastases progressing after hepatic arterial pump and systemic chemotherapy.
- Authors: Sofocleous CT, Garcia AR, Pandit-Taskar N, Do KG, Brody LA, Petre EN, Capanu M, Longing AP, Chou JF, Carrasquillo JA, Kemeny NE
- Issue date: 2014 Mar
- Selective Internal Radiation Therapy (SIRT) with yttrium-90 resin microspheres plus standard systemic chemotherapy regimen of FOLFOX versus FOLFOX alone as first-line treatment of non-resectable liver metastases from colorectal cancer: the SIRFLOX study.
- Authors: Gibbs P, Gebski V, Van Buskirk M, Thurston K, Cade DN, Van Hazel GA, SIRFLOX Study Group.
- Issue date: 2014 Dec 1
- Selective internal radiation therapy for liver metastases from colorectal cancer.
- Authors: Townsend AR, Chong LC, Karapetis C, Price TJ
- Issue date: 2016 Nov
- Phase II trial of selective internal radiation therapy and systemic chemotherapy for liver-predominant metastases from pancreatic adenocarcinoma.
- Authors: Gibbs P, Do C, Lipton L, Cade DN, Tapner MJ, Price D, Bower GD, Dowling R, Lichtenstein M, van Hazel GA
- Issue date: 2015 Oct 26
- SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer.
- Authors: van Hazel GA, Heinemann V, Sharma NK, Findlay MP, Ricke J, Peeters M, Perez D, Robinson BA, Strickland AH, Ferguson T, Rodríguez J, Kröning H, Wolf I, Ganju V, Walpole E, Boucher E, Tichler T, Shacham-Shmueli E, Powell A, Eliadis P, Isaacs R, Price D, Moeslein F, Taieb J, Bower G, Gebski V, Van Buskirk M, Cade DN, Thurston K, Gibbs P
- Issue date: 2016 May 20