Survival and tolerability of liver radioembolization: a comparison of elderly and younger patients with metastatic colorectal cancer

HPB (Oxford). 2014 Dec;16(12):1110-6. doi: 10.1111/hpb.12307. Epub 2014 Aug 15.

Abstract

Aim: To evaluate the outcomes among elderly (≥70 years) and younger patients (<70 years) with liver-dominant metastatic colorectal cancer (mCRC) who received radioembolization (RE) as salvage therapy.

Methods: A retrospective review of 107 consecutive patients with unresectable mCRC treated with RE after failing first- and second-line chemotherapy.

Results: From 2002 to 2012, 44 elderly and 63 younger (<70 years) patients received RE. Patients had similar previous extensive chemotherapy and liver-directed interventions. Using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria, either a stable or a partial radiographical response was seen in 65.8% of the younger compared with 76.5% of the elderly patients. RE was equally well tolerated in both groups and common procedure-related adverse events were predominantly grade 1-2 and of short duration. No significant difference was found with regard to overall median survival between younger [8.4 months; 95% confidence interval (CI) = 6.2-10.6] or elderly patients (8.2 months; 95% CI = 5.9-10.5, P = 0.667). The presence of extrahepatic disease at the time of RE was associated with a significantly worse median survival in both groups.

Conclusion: Radioembolization appears to be as well tolerated and effective for the elderly as it is for younger patients with mCRC. Age alone should not be a discriminating factor for the use of radioembolization in the management of mCRC patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Embolization, Therapeutic / mortality
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Patient Selection
  • Proportional Hazards Models
  • Radiopharmaceuticals / adverse effects
  • Radiopharmaceuticals / therapeutic use*
  • Retrospective Studies
  • Salvage Therapy
  • Time Factors
  • Treatment Outcome

Substances

  • Radiopharmaceuticals