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Analysis of a National Programme for Selective Internal Radiation Therapy for Colorectal Cancer Liver Metastases

Lookup NU author(s): Professor Derek Manas


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© 2018 Aims: Patients 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. Methods: Patients 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). Results: Between 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. Conclusion: Survival 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.

Publication metadata

Author(s): White J, Carolan-Rees G, Dale M, Morgan HE, Patrick HE, See TC, Beeton EL, Swinson DEB, Bell JK, Manas DM, Crellin A, Slevin NJ, Sharma RA

Publication type: Article

Publication status: Published

Journal: Clinical Oncology

Year: 2018

Volume: 31

Issue: 1

Pages: 58-66

Print publication date: 01/01/2019

Online publication date: 05/10/2018

Acceptance date: 01/08/2018

ISSN (print): 0936-6555

ISSN (electronic): 1433-2981

Publisher: Elsevier Ltd


DOI: 10.1016/j.clon.2018.09.002


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