Safety of Repeated Radioembolizations in Patients with Advanced Primary and Secondary Liver Tumors and Progressive Disease After First Selective Internal Radiotherapy

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FIGURE 1.
Bilirubin trend during observation period. CI = confidence interval; proc. = procedure.
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FIGURE 2.
OS (mo).

TABLE 1

Patient Characteristics

Characteristic	Data (n = 21)
Sex
Male	9
Female	12
Cancer type
Colorectal cancer	5
Breast cancer	7
HCC	8
Cholangiocellular carcinoma	1
Age (y)
Mean	61
Range	34–75
Initial tumor load (%)
Mean	19
Range	5–50
Extrahepatic metastases present	11
Concomitant treatment
Local ablation	4
Sorafenib	4 (of 8 HCC patients)
Systemic chemotherapy	2

TABLE 2

Previous Systemic Treatments

Patient no.	Diagnosis	No. of lines	Schemes and substances
1	Colorectal cancer	1	FOLFOX/cetuximab
2	Breast cancer	5	FEC, vinorelbine/trastuzumab, capecitabine/trastuzumab, paclitaxel/trastuzumab, capecitabine/lapatinib
3	Colorectal cancer	1	FOLFIRI/bevacizumab
4	HCC	0
5	HCC	0
6	Cholangiocellular carcinoma	4	FUFOX, gemcitabine, sorafenib, cetuximab
7	Colorectal cancer	3	FOLFOX, FOLFIRI, FOLFIRI/bevacizumab
8	HCC	1	Sorafenib
9	Breast cancer	5	Paclitaxel/epirubicin, docetaxel/capecitabine, docetaxel/5-fluorouracil, vinorelbine, doxorubicin
10	Colorectal cancer	0
11	HCC	0
12	Breast cancer	1	Docetaxel
13	HCC	1	Sorafenib
14	HCC	1	Sorafenib
15	Colorectal cancer	1	FOLFIRI
16	Breast cancer	1	Capecitabine
17	Breast cancer	2	FEC, aromatasin inhibitor
18	Breast cancer	4	FEC, docetaxel, capecitabine, doxorubicin
19	Breast cancer	2	FEC, vinorelbine/capecitabine
20	HCC	1	Sorafenib
21	HCC	1	Sorafenib

FOLFOX = folinic acid, fluorouracil, oxaliplatin; FEC = fluorouracil, epirubicin, cyclophosphamide; FOLFIRI = folinic acid, fluorouracil, irinotecan; FUFOX = fluorouracil, folinic acid, oxaliplatin.

TABLE 3

Frequency of Adverse Events

		Grade
Parameter	Cycle	I	II	III
No. of CTCAEs
HCC (n = 8)	1	16	5	1
	2	25	2	0
Metastases/cholangiocellular carcinoma (n = 13)	1	28	6	1
	2	31	12	1
Percentage of patients (%)
HCC (n = 8)	1	75	50	13
	2	100	25	—
Metastases/cholangiocellular carcinoma (n = 13)	1	92	38	8
	2	92	54	8

TABLE 4

Treatment Characteristics

Characteristic	Data	Statistical significance
No. of radioembolization procedures (unilobar)
3	16
4	4
5	1
Mean no. of whole-liver radioembolization per patient	1.6
Shunt (%)
First evaluation	5.4 (n = 21)
Second evaluation	9.8 (n = 14)	P > 0.05
Dose reduction	5
Cumulative total dose applied (GBq)
Mean	2.57
SD	0.63
Range	1.55–4.15

TABLE 5

Severity and Type of Adverse Events