TY - JOUR
T1 - Safety and efficacy of radioembolization in elderly (≥ 70 years) and younger patients with unresectable liver-dominant colorectal cancer
AU - Kennedy, Andrew S.
AU - Ball, David S.
AU - Cohen, Steven J.
AU - Cohn, Michael
AU - Coldwell, Douglas
AU - Drooz, Alain
AU - Ehrenwald, Eduardo
AU - Kanani, Samir
AU - Rose, Steven C.
AU - Nutting, Charles W.
AU - Moeslein, Fred M.
AU - Savin, Michael A.
AU - Schirm, Sabine
AU - Putnam, Samuel G.
AU - Sharma, Navesh K.
AU - Wang, Eric A.
N1 - Funding Information:
This study was supported in part by Sirtex Medical through an investigator-initiated trial grant request by A.S.K. The authors designed the study, collected and analyzed the data, interpreted the data, and drafted the manuscript. They decided on submission for publication without any involvement in the preceding tasks by the funding source.
Publisher Copyright:
© 2016 Elsevier Inc. All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background The effects of advancing age on clinical outcomes after radioembolization (RE) in patients with unresectable liver-dominant metastatic colorectal cancer (mCRC) are largely unknown. Patients and Methods This study was a retrospective analysis of 160 elderly (≥ 70 years) and 446 younger (< 70 years) consecutive patients from 11 US centers who received RE using ytrrium-90 (90Y) resin microspheres (90Y radioembolization [90Y-RE]) between July 2002 and December 2011. A further analysis was conducted in 98 very elderly patients (≥ 75 years). Statistical analyses of safety, tolerability, and overall survival were conducted. Results Mean ages (± standard deviation) in the younger (< 70 years), elderly (≥ 70 years), and very elderly (≥ 75 years) cohorts were 55.9 ± 9.4 years, 77.2 ± 4.8 years, and 80.2 ± 3.8 years, respectively. Overall survival was similar between elderly and younger patients: 9.3 months (95% confidence interval [CI], 8.0-12.1) and 9.7 months (95% CI, 9.0-11.4) (P =.335). There were no differences between cohorts for any grade adverse events (P =.433) or grade 3+ events (P =.482). Analysis of patients ≥ 75 years and < 75 years confirmed similar overall survival (median, 9.3 months vs. 9.6 months, respectively; P =.987) and grade 3+ events (P =.398) or any adverse event (P =.158) within 90 days of RE. Conclusion For patients with unresectable liver-dominant mCRC who meet eligibility criteria for RE, 90Y-RE microspheres appear to be effective and well-tolerated, regardless of age. Criteria for selecting patients for RE should not include age for exclusion from this potentially beneficial intervention.
AB - Background The effects of advancing age on clinical outcomes after radioembolization (RE) in patients with unresectable liver-dominant metastatic colorectal cancer (mCRC) are largely unknown. Patients and Methods This study was a retrospective analysis of 160 elderly (≥ 70 years) and 446 younger (< 70 years) consecutive patients from 11 US centers who received RE using ytrrium-90 (90Y) resin microspheres (90Y radioembolization [90Y-RE]) between July 2002 and December 2011. A further analysis was conducted in 98 very elderly patients (≥ 75 years). Statistical analyses of safety, tolerability, and overall survival were conducted. Results Mean ages (± standard deviation) in the younger (< 70 years), elderly (≥ 70 years), and very elderly (≥ 75 years) cohorts were 55.9 ± 9.4 years, 77.2 ± 4.8 years, and 80.2 ± 3.8 years, respectively. Overall survival was similar between elderly and younger patients: 9.3 months (95% confidence interval [CI], 8.0-12.1) and 9.7 months (95% CI, 9.0-11.4) (P =.335). There were no differences between cohorts for any grade adverse events (P =.433) or grade 3+ events (P =.482). Analysis of patients ≥ 75 years and < 75 years confirmed similar overall survival (median, 9.3 months vs. 9.6 months, respectively; P =.987) and grade 3+ events (P =.398) or any adverse event (P =.158) within 90 days of RE. Conclusion For patients with unresectable liver-dominant mCRC who meet eligibility criteria for RE, 90Y-RE microspheres appear to be effective and well-tolerated, regardless of age. Criteria for selecting patients for RE should not include age for exclusion from this potentially beneficial intervention.
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U2 - 10.1016/j.clcc.2015.09.001
DO - 10.1016/j.clcc.2015.09.001
M3 - Article
C2 - 26541321
AN - SCOPUS:84960877692
VL - 15
SP - 141-151.e6
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
SN - 1533-0028
IS - 2
ER -