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    Analysis of a National Programme for Selective Internal Radiation Therapy for Colorectal Cancer Liver Metastases

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    Authors
    White, J
    Carolan-Rees, G
    Dale, M
    Morgan, HE
    Patrick, HE
    See, TC
    Beeton, EL
    Swinson, DEB
    Bell, Jon
    Manas, DM
    Crellin, A
    Slevin, Nicholas J
    Sharma, RA
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    Affiliation
    Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Cardiff, UK
    Issue Date
    2018
    
    Metadata
    Show full item record
    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.
    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.
    Journal
    Clin Oncol (R Coll Radiol )
    URI
    http://hdl.handle.net/10541/621358
    DOI
    10.1016/j.clon.2018.09.002
    PubMed ID
    30297164
    Additional Links
    https://dx.doi.org/10.1016/j.clon.2018.09.002
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.clon.2018.09.002
    Scopus Count
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