Analysis of a National Programme for Selective Internal Radiation Therapy for Colorectal Cancer Liver Metastases |
| |
Authors: | J. White G. Carolan-Rees M. Dale H.E. Morgan H.E. Patrick T.C. See E.L. Beeton D.E.B. Swinson J.K. Bell D.M. Manas A. Crellin N.J. Slevin R.A. Sharma |
| |
Affiliation: | 1. Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Cardiff, UK;2. Cedar, Cardiff University, Cardiff Medicentre, Cardiff, UK;3. Centre for Health Technology Evaluation, National Institute for Health and Care Excellence, London, UK;4. Cambridge University Hospitals NHS Foundation Trust, Addenbrooke''s Hospital, Cambridge, UK;5. Nottingham University Hospitals NHS Trust, Nottingham, UK;7. Department of Radiology, The Christie NHS Foundation Trust, Manchester, UK;11. The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK;12. NHS England, Institute of Oncology, St James''s University Hospital, Leeds, UK;8. The Christie NHS Foundation Trust, Withington, Manchester, UK;9. NIHR University College London Hospitals Biomedical Research Centre, UCL Cancer Institute, University College London, London, UK |
| |
Abstract: | AimsPatients with chemotherapy-refractory colorectal cancer liver metastases have limited therapeutic options. Selective internal radiation therapy (SIRT) delivers yttrium 90 microspheres as a minimally invasive procedure. This prospective, single-arm, observational, service-evaluation study was part of National Health Service England Commissioning through Evaluation.MethodsPatients eligible for treatment had histologically confirmed carcinoma with liver-only/liver-dominant metastases with clinical progression during or following oxaliplatin-based and irinotecan-based chemotherapy. All patients received SIRT plus standard of care. The primary outcome was overall survival; secondary outcomes included safety, progression-free survival (PFS) and liver-specific PFS (LPFS).ResultsBetween December 2013 and March 2017, 399 patients were treated in 10 centres with a median follow-up of 14.3 months (95% confidence interval 9.2–19.4). The median overall survival was 7.6 months (95% confidence interval 6.9–8.3). The median PFS and LPFS were 3.0 months (95% confidence interval 2.8–3.1) and 3.7 months (95% confidence interval 3.2–4.3), respectively. During the follow-up period, 143 patients experienced an adverse event and 8% of the events were grade 3.ConclusionSurvival estimates from this pragmatic study show clinical outcomes attainable in the National Health Service comparable with previously published data. This study shows the value of a registry-based commissioning model to aid national commissioning decisions for highly specialist cancer treatments. |
| |
Keywords: | Brachytherapy colorectal cancer commissioning models liver metastases molecular radiotherapy transarterial radio-embolisation |
本文献已被 ScienceDirect 等数据库收录! |
|