Abstract：
OBJECTIVE: To characterize the response and survival outcomes of yttrium-90 transarterial radioembolization (90Y-TARE) for unresectable, liver-dominant metastases from primary neoplasms other than colorectal carcinoma.
METHODS: This study included 1474 patients enrolled in the RESiN registry who received resin 90Y-TARE as part of their oncologic management for unresectable primary or secondary liver tumors (NCT02685631). 33% (481/1474) were treated for liver metastases of non-colorectal origin (m-nonCRC), compared to 34% (497/1474) treated for colorectal liver metastases (mCRC) and 34% (496/1474) treated for hepatocellular carcinoma (HCC). Treatment response and cancer survival probabilities were computed and compared for each primary cancer type. The Kaplan-Meier method and log-rank test were used to compare survival outcomes.
RESULTS: Radiological responses were observed in 12 unique cancer types, mostly heavily pre-treated malignancies refractory to multiple lines of systemic therapies. The overall use of resin 90Y-TARE in m-nonCRC resulted in better treatment outcomes in terms of duration of response, progression free survival, time to progression and overall survival (P = 0.04, P = 0.02, P = 0.01, P = 0.04). Analyses of cancer cell types revealed that metastatic neuroendocrine tumor, sarcoma, and ovarian, renal, prostate, and breast cancers were associated with superior treatment outcomes, whereas worse treatment outcomes were observed in metastatic lung, gastric, pancreatic and esophageal cancers.
CONCLUSIONS: Real-world data demonstrate the use of resin 90Y-TARE in m-nonCRC refractory to standard chemotherapy. For some cell types, this expanded use achieved superior treatment outcomes relative to the reference standard of mCRC, suggesting the need for inquiry into broadened indications for 90Y-TARE.
METHODS: This study included 1474 patients enrolled in the RESiN registry who received resin 90Y-TARE as part of their oncologic management for unresectable primary or secondary liver tumors (NCT02685631). 33% (481/1474) were treated for liver metastases of non-colorectal origin (m-nonCRC), compared to 34% (497/1474) treated for colorectal liver metastases (mCRC) and 34% (496/1474) treated for hepatocellular carcinoma (HCC). Treatment response and cancer survival probabilities were computed and compared for each primary cancer type. The Kaplan-Meier method and log-rank test were used to compare survival outcomes.
RESULTS: Radiological responses were observed in 12 unique cancer types, mostly heavily pre-treated malignancies refractory to multiple lines of systemic therapies. The overall use of resin 90Y-TARE in m-nonCRC resulted in better treatment outcomes in terms of duration of response, progression free survival, time to progression and overall survival (P = 0.04, P = 0.02, P = 0.01, P = 0.04). Analyses of cancer cell types revealed that metastatic neuroendocrine tumor, sarcoma, and ovarian, renal, prostate, and breast cancers were associated with superior treatment outcomes, whereas worse treatment outcomes were observed in metastatic lung, gastric, pancreatic and esophageal cancers.
CONCLUSIONS: Real-world data demonstrate the use of resin 90Y-TARE in m-nonCRC refractory to standard chemotherapy. For some cell types, this expanded use achieved superior treatment outcomes relative to the reference standard of mCRC, suggesting the need for inquiry into broadened indications for 90Y-TARE.
摘要：
目的：为了表征钇90经动脉放射栓塞（90Y-TARE）的反应和生存结果，结直肠癌以外的原发性肿瘤的肝显性转移。
方法：本研究纳入了1474名参加RESiN注册的患者，他们接受90Y-TARE树脂作为肿瘤治疗不可切除的原发性或继发性肝肿瘤的一部分（NCT02685631）。33％（481/1474）治疗非结直肠起源的肝转移（m-nonCRC），与34％（497/1474）治疗结直肠癌肝转移（mCRC）和34％（496/1474）治疗肝细胞癌（HCC）相比。计算并比较每种原发性癌症类型的治疗反应和癌症生存概率。使用Kaplan-Meier方法和对数秩检验比较生存结果。
结果：在12种独特的癌症类型中观察到放射学反应，大多数是经过大量预处理的恶性肿瘤，对多种系统治疗无效。在m-nonCRC中使用树脂90Y-TARE在反应持续时间方面获得了更好的治疗结果。无进展生存期，进展时间和总生存期(P=0.04,P=0.02,P=0.01,P=0.04).癌细胞类型的分析表明，转移性神经内分泌肿瘤，肉瘤,和卵巢，肾,前列腺,乳腺癌与优越的治疗结果相关，而在转移性肺中观察到较差的治疗结果，胃,胰腺癌和食道癌。
结论：真实世界数据表明90Y-TARE树脂在标准化疗难治的m-nonCRC中的应用。对于某些细胞类型，相对于mCRC的参考标准，这种扩大的使用取得了更好的治疗结果，这表明有必要对90年代的适应症进行调查。
方法：本研究纳入了1474名参加RESiN注册的患者，他们接受90Y-TARE树脂作为肿瘤治疗不可切除的原发性或继发性肝肿瘤的一部分（NCT02685631）。33％（481/1474）治疗非结直肠起源的肝转移（m-nonCRC），与34％（497/1474）治疗结直肠癌肝转移（mCRC）和34％（496/1474）治疗肝细胞癌（HCC）相比。计算并比较每种原发性癌症类型的治疗反应和癌症生存概率。使用Kaplan-Meier方法和对数秩检验比较生存结果。
结果：在12种独特的癌症类型中观察到放射学反应，大多数是经过大量预处理的恶性肿瘤，对多种系统治疗无效。在m-nonCRC中使用树脂90Y-TARE在反应持续时间方面获得了更好的治疗结果。无进展生存期，进展时间和总生存期(P=0.04,P=0.02,P=0.01,P=0.04).癌细胞类型的分析表明，转移性神经内分泌肿瘤，肉瘤,和卵巢，肾,前列腺,乳腺癌与优越的治疗结果相关，而在转移性肺中观察到较差的治疗结果，胃,胰腺癌和食道癌。
结论：真实世界数据表明90Y-TARE树脂在标准化疗难治的m-nonCRC中的应用。对于某些细胞类型，相对于mCRC的参考标准，这种扩大的使用取得了更好的治疗结果，这表明有必要对90年代的适应症进行调查。
