A Comparison of Yttrium-90 Microsphere Radioembolization to Hepatic Arterial Infusional Chemotherapy for Patients with Chemo-refractory Hepatic Colorectal Metastases

Curr Treat Options Oncol. 2017 Jul;18(7):42. doi: 10.1007/s11864-017-0481-1.

Abstract

Patients with unresectable hepatic colorectal metastases who become chemo-refractory have limited treatment options. Systemic chemotherapies such as TAS102 and regorafenib have been used in the refractory setting, but with only modest improvement in overall survival compared to best supportive care. In patients with liver-only or liver-dominant disease, direct chemotherapy to the liver such as hepatic artery infusional (HAI) chemotherapy and radioembolization (yttrium-90 (Y90)) should be considered. Due to the difficulty of HAI therapy post Y90 for technical reasons, we recommend HAI therapy prior to Y90.

Keywords: Hepatic arterial infusion; Metastatic colorectal cancer; Refractory; Survival; Yttrium-90 microsphere radioembolization.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Drug Resistance, Neoplasm
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Intra-Arterial
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Male
  • Microspheres*
  • Middle Aged
  • Radiopharmaceuticals*
  • Retreatment
  • Treatment Outcome
  • Young Adult
  • Yttrium Radioisotopes*

Substances

  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • Yttrium-90