Evaluation of the Effectiveness of Radioembolization Therapy in Colorectal Cancer Liver Metastases

Abstract

Colorectal cancer (CRC) ranks among the foremost causes of cancer-related mortality, with liver metastases (colorectal liver metastases, CLM) considerably affecting prognosis. While surgery is the gold standard for curative treatment, the majority of patients are ineligible due to disease extent or comorbidities. Radioembolization with yttrium-90 (Y-90) microspheres has emerged as a promising locoregional therapy for unresectable CLM. However, its effectiveness in improving survival and tumor control remains an area of active investigation. The clinical results of 59 colorectal cancer patients with liver metastases who received radioembolization treatment were assessed. Treatment response was assessed using imaging modalities, including PET-CT, MRI, and CT. The primary endpoints were overall survival (OS) and treatment response, while secondary outcomes included toxicity profiles and prognostic factors influencing survival. The cohort’s median OS was 9 months, with a mean OS of 13.2 months. Patients exhibiting metabolic response on PET-CT had significantly longer survival (19.3 months) compared to non-responders (8.3 months, p = 0.042). Extrahepatic disease was a strong prognostic factor, with patients without extrahepatic involvement showing a significantly lower OS (7.1 vs. 21 months, p = 0.000). Bilobar disease also negatively impacted survival (p = 0.003). Nearly all patients experienced mild to moderate side effects, with the most common being abdominal pain, nausea, and vomiting. Severe toxicities were rare, although one patient developed a gastric ulcer.Y-90 radioembolization is an effective and relatively safe treatment for unresectable CLM, particularly in patients without extrahepatic disease. The strong association between metabolic response and survival underscores the potential of PET-CT as a prognostic indicator. Further prospective studies are needed to refine patient selection criteria and optimize treatment protocols.

Keywords

• colorectal cancer
• radioembolization
• liver metastases

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