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Irish Journal of Medical Science (1971 -)

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01-02-2019 | Original Article

Single-institution experience with selective internal radiation therapy (SIRT) for the treatment of unresectable colorectal liver metastases

Authors: Cathal O’Leary, Megan Greally, John McCaffrey, Peter Hughes, Leo L. P. Lawler, Martin O’Connell, Tony Geoghegan, Cormac Farrelly

Published in: Irish Journal of Medical Science (1971 -) | Issue 1/2019

Abstract

Background

Liver metastases are the commonest cause of death for patients with colorectal cancer. Growing evidence supports the use of selective internal radiation therapy (SIRT) in combination with conventional chemotherapy regimens for liver-only or liver-dominant unresectable metastatic colorectal cancer.

Aims

To measure and evaluate outcomes of the first 20 consecutive patients with unresectable colorectal liver metastasis selected for SIRT in addition to their chemotherapy at a single Irish institution.

Methods

Retrospective case series was performed. Patient charts and medical records were reviewed.

Results

All 20 patients (100%) selected for angiographic workup were subsequently successfully treated with radioembolization. All patients were discharged 1 day post-SIRT. At initial imaging evaluation, 12 (60%) had a partial response in their liver, 2 (10%) had stable disease, and 6 (30%) had liver-specific progressive disease. Median follow up was 10 months (range 6–26). At last follow up, 14 (70%) patients were alive and 6 (30%) deceased. Most recent imaging demonstrated 2 (10%) with a complete response, 7 (35%) had a partial response, 2 (10%) had stable disease, and 9 (45%) had progressive disease within their liver. One patient was downstaged to hepatic resection, and one with a complete hepatic response had his primary sigmoid tumor resected 11 months post-SIRT.

Conclusions

SIRT is a safe and effective therapy for certain patients with unresectable colorectal liver metastases. This case series supports our opinion that selected patients should be offered SIRT in concert with their medical oncologist, concomitant with their chemotherapy. Larger multi-center studies are required to more clearly define the patient groups that will derive most benefit from SIRT.

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Title: Single-institution experience with selective internal radiation therapy (SIRT) for the treatment of unresectable colorectal liver metastases
Authors: Cathal O’Leary
Megan Greally
John McCaffrey
Peter Hughes
Leo L. P. Lawler
Martin O’Connell
Tony Geoghegan
Cormac Farrelly
Publication date: 01-02-2019
Publisher: Springer London
Published in: Irish Journal of Medical Science (1971 -) / Issue 1/2019
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-018-1773-6

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Aims

Methods

Results

Conclusions

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Other articles of this Issue 1/2019

Obesity, diet and lifestyle in 9-year-old children with parentally reported chronic diseases: findings from the Growing Up in Ireland longitudinal child cohort study

Coeliac screening in a high-risk population: paediatric type 1 diabetes—a review of current guidelines and practice

Towards a more positive view of healthcare in Ireland

Trends in the treatment of chronic kidney disease-associated anaemia in a cohort of haemodialysis patients: the Irish experience

Breast cancers missed by screening radiologists can be detected by reading mammograms at a distance

A profile of physiotherapy supply in Ireland

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials