Selective internal radiation therapy (SIRT) in metastatic colorectal cancer (mCRC): safety, efficacy and survival outcomes from the South Australian Registry — ASN Events
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Selective internal radiation therapy (SIRT) in metastatic colorectal cancer (mCRC): safety, efficacy and survival outcomes from the South Australian Registry (#99)

Adeola Ayoola 1 , Sina Vantandoust 1 , Amitesh Roy 1 , Tim Price 2 3 , Michael Kitchener 4 , David Roder 5 , Steven Quinn 6 , Ganessan Kichenadasse 1 7 , Cynthia Piantadosi 7 , R Padbury 6 8 , Chris Karapetis 1 7
  1. Flinders Medical Center, Bedford Park, SA, Australia
  2. Dept. of Medical Oncology, The Queen Elizabeth Hospital, Adelaide, SA, Australia
  3. Department of Surgery, University of Adelaide, Adelaide, SA, Australia
  4. Dept. of Nuclear Medicine, , The Queen Elizabeth Hospital, Adelaide, SA, Australia
  5. University of South Australia, Adelaide, SA, Australia
  6. Flinders University, Adelaide, SA, Australia
  7. Flinders Centre for Innovation in Cancer,, Flinders University., Adelaide, SA, Australia
  8. Dept. of Surgery, Flinders Medical Centre, Adelaide, SA, Australia

Background: Colorectal cancer remains one of the commonly diagnosed cancers. The liver is the most common site of metastatic disease and the majority of patients eventually die from cancer progression in the liver. We report on the South Australian experience of the use of liver directed treatment with SIRT and we analyze the safety and efficacy of this intervention.

Method and Patient Characteristics: Data was obtained from the State-wide Metastatic Colorectal Cancer Registry which was established in 2006. Patients treated with SIRT were identified. The objectives were to determine time to hepatic progression (THP), overall survival, response rate, acute toxicity and safety of SIRT.

55 patients (37 males; 18 Females) were treated with SIRT from 2006-2015. The median age was 67.5 years. 70% had ECOG score < 2. 44 (80%) patients had liver limited disease; 11 (20%) had extra-hepatic disease. 4 (7%) patients had SIRT with first line chemotherapy; 22 (40%) had SIRT after ≥4 lines of chemotherapy; 10 (18.2%) received SIRT concurrent with chemotherapy; 45 (81.8%) had SIRT alone; Only 1 patient had SIRT twice.

Results: The median (THP) was 3.72 (95% CI. 2.26-4.83) months; the median survival was 10.6 (95% CI. 7.73-15.32) months. Patients with liver limited disease vs extra-hepatic disease showed no difference in median survival (14.2 vs 10.6months, p=0.67). In other univariable analyses, there was no significant difference in survival according to age, ECOG, lines of chemotherapy, number of liver lesions or presence of extra-hepatic disease. The radiological response rate was 14.2%.

There was no grade 3 or 4 acute toxicity. The most common short-term adverse effects were hepatic pain (18%), nausea, vomiting and back pain. Data regarding potential long term toxicity was not systemically collected.

Conclusion: In this population based analysis, SIRT was mostly administered in pre-treated patients and we observed activity with an acceptable short term safety profile.