Radioembolization for treatment of salvage patients with colorectal cancer liver metastases: A systematic review

Abstract

Currently, there is no consensus on the use of 90 Y radioembolization for salvage patients with colorectal cancer liver metastases. The purpose of this study was to provide a comprehensive overview of the available data on tumor response and survival after 90 Y radioembolization for this group of patients. Methods: A systematic literature search was conducted in PubMed (Medline), Excerpta Medica (EMBASE), and the Cochrane Library (September 2012) with synonyms for " radioembolization" and "colorectal cancer liver metastases." Results were described separately for patient cohorts treated with 90 Y radioembolization as monotherapy and with 90 Y radioembolization in combination with chemotherapy. Results: The search yielded 13 relevant articles for systematic review on 90 Y radioembolization as monotherapy and 13 relevant articles on 90 Y radioembolization combined with chemotherapy. Disease control rates (i.e., complete response, partial response, and stable disease) ranged from 29% to 90% for 90 Y radioembolization as monotherapy and from 59% to 100% for 90 Y radioembolization combined with chemotherapy. Heterogeneity in the data prohibited pooling of response rates. Survival proportions at 12 mo ranged from 37% to 59% for 90 Y radioembolization as monotherapy and from 43% to 74% for 90 Y radioembolization combined with chemotherapy. Conclusion: In the studies included in this systematic review, approximately 50% of salvage patients with colorectal cancer liver metastases survive more than 12 mo after treatment with 90 Y radioembolization, either as monotherapy or in combination with chemotherapy. Heterogeneity between studies has unfortunately prohibited pooling of data. Future research will discern the precise role of 90 Y radioembolization in general clinical practice in comparison with chemotherapy. © 2013 by the Society of Nuclear Medicine and Molecular Imaging, Inc.