Internal selective radiotherapy improves the outcomes of patients with colorectal cancer liver metastasis

This study investigated the effectiveness of selective internal radiation therapy (SIRT) in the treatment of colorectal cancer liver metastasis (CRC-LM). Researchers suggested that adding this therapy to the treatment improves the outcomes of the treatment.

The liver is a common site for colorectal cancer metastasis (spread to other parts of the body). More aggressive surgery approaches have resulted in a higher number of survivors. However, for 80 to 90% of these patients, CRC-LM are not operable at diagnosis. These patients get treatment such as surgery and/or chemotherapy to remove or shrink the CRC-LM, so it becomes operable. However, the best method for this remains unclear.

Prior studies showed that selective internal radiation therapy (SIRT) is associated with improved tumor response. This method consists of putting radioactive beads in the blood vessels around the liver tumor. The radiation in the beads destroys the cancer cells causing little damage to healthy cells. To date, there are no studies about how this therapy could turn inoperable CRC-LM into operable.

This study included 472 patients with CRC-LM. All patients received chemotherapy. Some patients also received targeted therapy (bevacizumab; Avastin). 244 of all patients received SIRT and 228 did not (control group). Patients were assessed before the treatment and at follow-up by liver imaging (CT-scan).

At follow-up, more patients in both groups (33.7%) had operable CRLM when compared to before the treatment (11.4%). However, more patients were operable in the SIRT group (38.1%) when compared to the control group (28.9%).

This study concluded that selective internal radiation therapy is associated with better inoperable CRC-LM response.