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Kennedy AS , Ball DS , Cohen SJ , Cohn M , Coldwell D , Drooz A , Ehrenwald E , Kanani S , Rose SC , Nutting CW , Moeslein FM , Savin MA , Schirm S , Putnam SG 3rd , Sharma NK , Wang EA , Metastatic Colorectal Cancer Liver Metastases Outcomes After Radioembolization Study Investigators
Safety and Efficacy of Radioembolization in Elderly (>/= 70 Years) and Younger Patients With Unresectable Liver-Dominant Colorectal Cancer
Clin Colorectal Cancer. 2016 Jun;15(2) :141-151 e6
PMID: 26541321 URL: http://www.ncbi.nlm.nih.gov/pubmed/26541321
AbstractBACKGROUND: 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 ((90)Y) resin microspheres ((90)Y radioembolization [(90)Y-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, (90)Y-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.
NotesKennedy, Andrew S Ball, David S Cohen, Steven J Cohn, Michael Coldwell, Douglas Drooz, Alain Ehrenwald, Eduardo Kanani, Samir Rose, Steven C Nutting, Charles W Moeslein, Fred M Savin, Michael A Schirm, Sabine Putnam, Samuel G 3rd Sharma, Navesh K Wang, Eric A (MORE) eng 2015/11/07 06:00 Clin Colorectal Cancer. 2016 Jun;15(2):141-151.e6. doi: 10.1016/j.clcc.2015.09.001. Epub 2015 Nov 2.