Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.

<h4>Objective</h4>To investigate clinical and laboratory toxicity in patients with unresectable liver metastases, treated with yttrium-90 radioembolization ((90)Y-RE).<h4>Methods</h4>Patients with liver metastases treated with (90)Y-RE, between February 1(st) 2009 and March 3...

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Autores principales:	Maarten L J Smits, Andor F van den Hoven, Charlotte E N M Rosenbaum, Bernard A Zonnenberg, Marnix G E H Lam, Johannes F W Nijsen, Miriam Koopman, Maurice A A J van den Bosch
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/11eae1dedb48492a99511a4c54842131
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spelling	oai:doaj.org-article:11eae1dedb48492a99511a4c548421312021-11-18T09:03:07ZClinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.1932-620310.1371/journal.pone.0069448https://doaj.org/article/11eae1dedb48492a99511a4c548421312013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23894481/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To investigate clinical and laboratory toxicity in patients with unresectable liver metastases, treated with yttrium-90 radioembolization ((90)Y-RE).<h4>Methods</h4>Patients with liver metastases treated with (90)Y-RE, between February 1(st) 2009 and March 31(st) 2012, were included in this study. Clinical toxicity assessment was based on the reporting in patient's charts. Laboratory investigations at baseline and during a four-month follow-up were used to assess laboratory toxicity according to the Common Terminology Criteria for Adverse Events version 4.02. The occurrence of grade 3-4 laboratory toxicity was stratified according to treatment strategy (whole liver treatment in one session versus sequential sessions). Response assessment was performed at the level of target lesions, whole liver and overall response in accordance with RECIST 1.1 at 3- and 6 months post-treatment. Median time to progression (TTP) and overall survival were calculated by Kaplan-Meier analysis.<h4>Results</h4>A total of 59 patients, with liver metastases from colorectal cancer (n = 30), neuroendocrine tumors (NET) (n = 6) and other primary tumors (n = 23) were included. Clinical toxicity after (90)Y-RE treatment was confined to grade 1-2 events, predominantly post-embolization symptoms. No grade 3-4 clinical toxicity was observed, whereas laboratory toxicity grade 3-4 was observed in 38% of patients. Whole liver treatment in one session was not associated with increased laboratory toxicity. Three-months disease control rates for target lesions, whole liver and overall response were 35%, 21% and 19% respectively. Median TTP was 6.2 months for target lesions, 3.3 months for the whole liver and 3.0 months for overall response. Median overall survival was 8.9 months.<h4>Conclusion</h4>The risk of severe complications or grade 3-4 clinical toxicity in patients with liver metastases of various primary tumors undergoing (90)Y-RE is low. In contrast, laboratory toxicity grade 3-4 can be expected to occur in more than one-third of patients without any clinical signs of radiation induced liver disease.Maarten L J SmitsAndor F van den HovenCharlotte E N M RosenbaumBernard A ZonnenbergMarnix G E H LamJohannes F W NijsenMiriam KoopmanMaurice A A J van den BoschPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 7, p e69448 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maarten L J Smits Andor F van den Hoven Charlotte E N M Rosenbaum Bernard A Zonnenberg Marnix G E H Lam Johannes F W Nijsen Miriam Koopman Maurice A A J van den Bosch Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.
description	<h4>Objective</h4>To investigate clinical and laboratory toxicity in patients with unresectable liver metastases, treated with yttrium-90 radioembolization ((90)Y-RE).<h4>Methods</h4>Patients with liver metastases treated with (90)Y-RE, between February 1(st) 2009 and March 31(st) 2012, were included in this study. Clinical toxicity assessment was based on the reporting in patient's charts. Laboratory investigations at baseline and during a four-month follow-up were used to assess laboratory toxicity according to the Common Terminology Criteria for Adverse Events version 4.02. The occurrence of grade 3-4 laboratory toxicity was stratified according to treatment strategy (whole liver treatment in one session versus sequential sessions). Response assessment was performed at the level of target lesions, whole liver and overall response in accordance with RECIST 1.1 at 3- and 6 months post-treatment. Median time to progression (TTP) and overall survival were calculated by Kaplan-Meier analysis.<h4>Results</h4>A total of 59 patients, with liver metastases from colorectal cancer (n = 30), neuroendocrine tumors (NET) (n = 6) and other primary tumors (n = 23) were included. Clinical toxicity after (90)Y-RE treatment was confined to grade 1-2 events, predominantly post-embolization symptoms. No grade 3-4 clinical toxicity was observed, whereas laboratory toxicity grade 3-4 was observed in 38% of patients. Whole liver treatment in one session was not associated with increased laboratory toxicity. Three-months disease control rates for target lesions, whole liver and overall response were 35%, 21% and 19% respectively. Median TTP was 6.2 months for target lesions, 3.3 months for the whole liver and 3.0 months for overall response. Median overall survival was 8.9 months.<h4>Conclusion</h4>The risk of severe complications or grade 3-4 clinical toxicity in patients with liver metastases of various primary tumors undergoing (90)Y-RE is low. In contrast, laboratory toxicity grade 3-4 can be expected to occur in more than one-third of patients without any clinical signs of radiation induced liver disease.
format	article
author	Maarten L J Smits Andor F van den Hoven Charlotte E N M Rosenbaum Bernard A Zonnenberg Marnix G E H Lam Johannes F W Nijsen Miriam Koopman Maurice A A J van den Bosch
author_facet	Maarten L J Smits Andor F van den Hoven Charlotte E N M Rosenbaum Bernard A Zonnenberg Marnix G E H Lam Johannes F W Nijsen Miriam Koopman Maurice A A J van den Bosch
author_sort	Maarten L J Smits
title	Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.
title_short	Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.
title_full	Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.
title_fullStr	Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.
title_full_unstemmed	Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.
title_sort	clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/11eae1dedb48492a99511a4c54842131
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Clinical and laboratory toxicity after intra-arterial radioembolization with (90)y-microspheres for unresectable liver metastases.

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