PDF(Pubmed)
Abstract：
Y-90 Selective Internal Radiotherapy (SIRT) is an ablative therapy used for inoperable liver metastasis. The purpose of this investigation was to examine the impact of local control after SIRT on overall survival (OS) in oligometastatic patients. A retrospective, single-institution study identified oligometastatic patients with ≤5 non-intracranial metastases receiving unilateral or bilateral lobar Y-90 SIRT from 2009 to 2021. The primary endpoint was OS defined from Y-90 SIRT completion to the date of death or last follow-up. Local failure was classified as a progressive disease at the target lesion(s) by RECIST v1.1 criteria starting at 3 months after SIRT. With a median follow-up of 15.7 months, 33 patients were identified who had a total of 79 oligometastatic lesions treated with SIRT, with the majority histology of colorectal adenocarcinoma (n = 22). In total, 94% of patients completed the Y-90 lobectomy. Of the 79 individual lesions treated, 22 (27.8%) failed. Thirteen patients received salvage liver-directed therapy following intrahepatic failure; ten received repeat SIRT. Median OS (mOS) was 20.1 months, and 12-month OS was 68.2%. Intralesional failure was associated with worse 1 y OS (52.3% vs. 86.2%, p = 0.004). These results suggest that intralesional failure following Y-90 may be associated with inferior OS, emphasizing the importance of disease control in low-metastatic-burden patients.
摘要：
Y-90选择性内部放射治疗（SIRT）是一种用于无法手术的肝转移的消融疗法。这项研究的目的是研究SIRT后局部控制对寡转移患者总生存期（OS）的影响。回顾，单机构研究确定了2009年至2021年间接受单侧或双侧大叶Y-90SIRT的≤5例非颅内转移的寡转移患者.主要终点是从Y-90SIRT完成到死亡日期或最后一次随访的OS定义。从SIRT后3个月开始,通过RECISTv1.1标准将局部失败分类为目标病变处的进行性疾病。中位随访时间为15.7个月，33例患者共79个寡转移病灶接受SIRT治疗，结直肠腺癌的组织学占多数（n=22）。总的来说,94%的患者完成了Y-90肺叶切除术。在治疗的79个单独病变中，22（27.8%）失败。13例患者在肝内衰竭后接受挽救性肝定向治疗;10例接受重复SIRT。中位OS(mOS)为20.1个月，12个月OS为68.2%。内胎故障与较差的1y操作系统相关(52.3%vs.86.2%,p=0.004)。这些结果表明，Y-90后的病灶内故障可能与操作系统较差有关，强调低转移负担患者疾病控制的重要性。
