Dimopoulos Marios-Platon, Sotirchos Vlasios S, Dunne-Jaffe Cynthia, Mitchell Ashara, Petre Elena N, Alexander Erica S, Gonen Mithat, Rao Devika, Connell Louise C, Soares Kevin, Katsanos Konstantinos, Sofocleous Constantinos T
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Interventional Radiology, University Hospital of Patras, Patras, Greece.
Cardiovasc Intervent Radiol. 2025 Sep 9. doi: 10.1007/s00270-025-04175-8.
To evaluate predictors of outcomes in colorectal liver metastases (CLM) patients undergoing 90Y radioembolization (TARE), focusing on the impact of tumor absorbed dose.
Patients' characteristics and dosimetry assessments were analyzed in 231 patients undergoing 329 TARE sessions from 09/2009 to 07/2023. Response was assessed using RECIST1.1 and PERCIST criteria.
Patients were predominantly male (137/231, 56.3%), had bilobar metastases (157/231, 68%) and received more than 3 lines of chemotherapy (144, 62.3%). Median age was 61 years (range 24-93). Glass and resin microspheres were used in 181/329(55%) and 148/329(45%) sessions, respectively. Weighted tumor absorbed dose covering at least 90% tumor (WTD90) ≥ 120 Gy (p = 0.043) and prior ablation (p = 0.016) were independent predictors of improved overall survival (OS) in the cohort. More than 10 CLMs (p < 0.001) and prior exposure to intra-arterial mitomycin-C (p = 0.015) were associated with decreased OS. Left colon (SHR: 1.680, 95% CI 1.136-2.484, p = 0.009) and rectal primary location (SHR: 1.586, 95% CI 1.005-2.504, p = 0.048) negatively impacted target liver progression-free survival (TLPFS), while intention to irradiate liver dose covering at least 50% tumor (ITILD50) had a positive impact (SHR: 0.955, 95% CI 0.926-0.984, p = 0.003) for the entire cohort. SIR Grade C and D complications were 1.2% and 2.7%, respectively, without correlation to dosimetry.
WTD ≥ 120 Gy was an independent predictor for improved OS after TARE for CLM regardless of microsphere type. High number of CLMs negatively impacted OS, while intention to irradiate liver dose covering at least 50% of the tumor positively impacted TLPFS.
评估接受钇-90放射性栓塞（TARE）治疗的结直肠癌肝转移（CLM）患者的预后预测因素，重点关注肿瘤吸收剂量的影响。
分析了2009年9月至2023年7月期间接受329次TARE治疗的231例患者的特征和剂量学评估。使用RECIST1.1和PERCIST标准评估反应。
患者以男性为主（137/231，56.3%），有双侧转移（157/231，68%），且接受过3线以上化疗（144例，62.3%）。中位年龄为61岁（范围24-93岁）。181/329（55%）和148/329（45%）次治疗分别使用了玻璃微球和树脂微球。加权肿瘤吸收剂量覆盖至少90%肿瘤（WTD90）≥120 Gy（p = 0.043）和既往消融（p = 0.016）是该队列中总生存期（OS）改善的独立预测因素。超过10个CLM（p < 0.001）和既往接受动脉内丝裂霉素-C治疗（p = 0.015）与OS降低相关。左半结肠（SHR：1.680，95%CI 1.136-2.484，p = 0.009）和直肠原发部位（SHR：1.586，95%CI 1.005-2.504，p = 0.048）对目标肝无进展生存期（TLPFS）有负面影响，而照射肝脏剂量覆盖至少50%肿瘤的意向（ITILD50）对整个队列有正面影响（SHR：0.955，95%CI 0.926-0.984，p = 0.003）。SIR C级和D级并发症分别为1.2%和2.7%，与剂量学无关。
无论微球类型如何，WTD≥120 Gy是CLM患者TARE治疗后OS改善的独立预测因素。大量CLM对OS有负面影响，而照射肝脏剂量覆盖至少50%肿瘤的意向对TLPFS有正面影响。
