PT  - JOURNAL ARTICLE
AU  - Ryan Hickey
AU  - Robert J. Lewandowski
AU  - Totianna Prudhomme
AU  - Eduardo Ehrenwald
AU  - Brian Baigorri
AU  - Jeffrey Critchfield
AU  - Joseph Kallini
AU  - Ahmed Gabr
AU  - Boris Gorodetski
AU  - Jean-Francois Geschwind
AU  - Andrea Abbott
AU  - Ravi Shridhar
AU  - Sarah B. White
AU  - William S. Rilling
AU  - Brendan Boyer
AU  - Shannon Kauffman
AU  - Sharon Kwan
AU  - Siddarth A. Padia
AU  - Vanessa L. Gates
AU  - Mary Mulcahy
AU  - Sheetal Kircher
AU  - Halla Nimeiri
AU  - Al B. Benson
AU  - Riad Salem
TI  - <sup>90</sup>Y Radioembolization of Colorectal Hepatic Metastases Using Glass Microspheres: Safety and Survival Outcomes from a 531-Patient Multicenter Study
AID  - 10.2967/jnumed.115.166082
DP  - 2016 May 01
TA  - Journal of Nuclear Medicine
PG  - 665--671
VI  - 57
IP  - 5
4099  - http://jnm.snmjournals.org/content/57/5/665.short
4100  - http://jnm.snmjournals.org/content/57/5/665.full
SO  - J Nucl Med2016 May 01; 57
AB  - Hepatic metastases of colorectal carcinoma are a leading cause of cancer-related mortality. Most colorectal liver metastases become refractory to chemotherapy and biologic agents, at which point the median overall survival declines to 4–5 mo. Radioembolization with 90Y has been used in the salvage setting with favorable outcomes. This study reports the survival and safety outcomes of 531 patients treated with glass-based 90Y microspheres at 8 institutions, making it the largest 90Y study for patients with colorectal liver metastases. Methods: Data were retrospectively compiled from 8 institutions for all 90Y glass microsphere treatments for colorectal liver metastases. Exposure to chemotherapeutic or biologic agents, prior liver therapies, biochemical parameters before and after treatment, radiation dosimetry, and complications were recorded. Uni- and multivariate analyses for predictors of survival were performed. Survival outcomes and clinical or biochemical adverse events were recorded. Results: In total, 531 patients received 90Y radioembolization for colorectal liver metastases. The most common clinical adverse events were fatigue (55%), abdominal pain (34%), and nausea (19%). Grade 3 or 4 hyperbilirubinemia occurred in 13% of patients at any time. The median overall survival from the first 90Y treatment was 10.6 mo (95% confidence interval, 8.8–12.4). Performance status, no more than 25% tumor burden, no extrahepatic metastases, albumin greater than 3 g/dL, and receipt of no more than 2 chemotherapeutic agents independently predicted better survival outcomes. Conclusion: This multiinstitutional review of a large cohort of patients with colorectal liver metastases treated with 90Y radioembolization using glass microspheres has demonstrated promising survival outcomes with low toxicity and low side effects. The outcomes were reproducible and consistent with prior reports of radioembolization.