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Clinical Trial
. 2005 Oct 15:5:132.
doi: 10.1186/1471-2407-5-132.

A prospective evaluation of treatment with Selective Internal Radiation Therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy

L Lim  1 , P Gibbs, D Yip, J D Shapiro, R Dowling, D Smith, A Little, W Bailey, M Liechtenstein
Affiliations
Clinical Trial

A prospective evaluation of treatment with Selective Internal Radiation Therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy

L Lim et al. BMC Cancer. .

Abstract

Background: To prospectively evaluate the efficacy and safety of Selective Internal Radiation (SIR) spheres in patients with inoperable liver metastases from colorectal cancer who have failed 5FU based chemotherapy.

Methods: Patients were prospectively enrolled at three Australian centres. All patients had previously received 5-FU based chemotherapy for metastatic colorectal cancer. Patients were ECOG 0-2 and had liver dominant or liver only disease. Concurrent 5-FU was given at investigator discretion.

Results: Thirty patients were treated between January 2002 and March 2004. As of July 2004 the median follow-up is 18.3 months. Median patient age was 61.7 years (range 36-77). Twenty-nine patients are evaluable for toxicity and response. There were 10 partial responses (33%), with the median duration of response being 8.3 months (range 2-18) and median time to progression of 5.3 mths. Response rates were lower (21%) and progression free survival shorter (3.9 mths) in patients that had received all standard chemotherapy options (n = 14). No responses were seen in patients with a poor performance status (n = 3) or extrahepatic disease (n = 6). Overall treatment related toxicity was acceptable, however significant late toxicity included 4 cases of gastric ulceration.

Conclusion: In patients with metastatic colorectal cancer that have previously received treatment with 5-FU based chemotherapy, treatment with SIR-spheres has demonstrated encouraging activity. Further studies are required to better define the subsets of patients most likely to respond.

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Figures

Figure 1
Figure 1
Survival curves for the 30 patients treated.
Figure 2
Figure 2
(A) Progression free survival for the two groups of patients, those that had previously received 5-FU or xeloda, and those that had received at least one oxaliplatin or irinotecan containing regimen. (B) Overall survival for the two groups of patients, those that had previously received 5-FU or xeloda, and those that had received at least one oxaliplatin or irinotecan containing regimen.
Figure 3
Figure 3
Biopsy of gastric mucosa showing inflammation (gastritis) from several SIR spheres, clearly visible.
See this image and copyright information in PMC

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