|Table of Contents|

The efficacy and safety of CT-guided 125I particle implantation in the treatment of liver metastases from colorectal cancer after failure of systemic chemotherapy without surgical resection

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 05
Page:
921-927
Research Field:
Publishing date:

Info

Title:
The efficacy and safety of CT-guided 125I particle implantation in the treatment of liver metastases from colorectal cancer after failure of systemic chemotherapy without surgical resection
Author(s):
JI Liqiu; HAO Shanhu; WANG Zhiguo; ZHANG Wenwen; ZHANG Guoxu
Department of Nuclear Medicine,General Hospital of Northern Theater Command,Liaoning Shenyang 110016,China.
Keywords:
125I intraparticle radiation therapy; palliative care; liver metastases from colorectal cancer
PACS:
R735.3+5
DOI:
10.3969/j.issn.1672-4992.2024.05.023
Abstract:
Objective:To evaluate the effectiveness and safety of CT-guided 125I particle implantation in the treatment of liver metastases from colorectal cancer after failure of systemic chemotherapy that cannot be surgically resected.Methods:We retrospectively analyzed the clinical data of 76 patients with liver metastases from colorectal cancer admitted our department of nuclear medicine of our hospital between January 2017 and October 2022 to evaluate the efficacy of particle implantation in hepatic metastases.We used two independent samples t-test and repeated-measures ANOVA to compare the differences between alanine aminotransferase and aspartate aminotransferase preoperatively and postoperatively.We analyzed the postoperative overall survival after particle implantation and compared the differences in OS in left-side colon cancer,right-side colon cancer,and rectal cancer respectively.Results:A total of 133 liver metastases were found in 76 patients,and the success rate of 125I particle implantation was 96.99% (129/133).The 6-month postoperative effective rate was 80.62%,and the local control rate was 89.92%.The differences of CEA,CA199,and AFP were statistically significant before and after treatment (t=2.803,5.015,and 2.221,all P＜0.05).The median OS after particle implantation was 26.25 months (range of 7.9~55) in 76 patients.The median OS after particle implantation for LSCC,RSCC,and rectal cancer was 32 months (range 8.5~55),21 months (range 7.9~35),and 26.5 months (range 8.2~42.2),respectively,and the comparison of the total OS showed liver metastasis of LSCC was significantly prolonged than RSCC and rectal cancer (χ2=10.42,P=0.005 5).Through further analyzing the KRAS wild-type subgroup,the OS of LSCC liver metastasis was also significantly prolonged compared with RSCC and rectal cancer(χ2=4.564,P=0.010 21).Conclusion:CT-guided 125I particle implantation was a safe and effective remedial treatment for inoperable liver metastases from colorectal cancer after failure of systemic chemotherapy.The overall survival rate of LSCC patients with liver metastases after 125I particle implantation was significantly higher than that of patients with liver metastases from RSCC and rectal cancer,especially the overall survival rate of LSCC patients with KRAS wild-type liver metastases was significantly higher than that of patients with liver metastases from RSCC and rectal cancer.

References:

［1］WANG H,SHI HB,QIANG WG,et al.CT-guided radioactive 125I seed implantation for abdominal incision metastases of colorectal cancer: Safety and efficacy in 17 patients［J］.Clin Colorectal Cancer,2023,22(1):136-142.
［2］EISENHAUER,EA THEARASSE,P BOGAERTS,et al.New response evaluation criteria in solid tumours:Revised RECIST guideline(version1.1)［J］.Eur J Cancer,2009,45(2):228-247.
［3］SUNG H,FERLAY J,SIEGEL RL,et al.Global cancer statistics 2020:Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries ［J］.CA Cancer J Clin,2021,71(3):209-249.
［4］MARTIN J,PETRILLO A,SMYTH E,et al.Colorectal liver metastases:Current management and future perspectives ［J］.World J Clin Oncol,2020,11(10):761-808.

［5］SUN G,ZHAO S,FAN Z,et al.CHSY1 promotes CD8+ T cell exhaustion through activation of succinate metabolism pathway leading to colorectal cancer liver metastasis based on CRISPR/Cas9 screening［J］.J Exp Clin Cancer Res,2023,42(1):248.
［6］FRANZ C,JOTTEN L,WUHRL M,et al.Protective effect of miR-18a in resected liver metastases of colorectal cancer and FOLFOX treatment［J］.Cancer Rep (Hoboken),2023,12:e1899.
［7］HEINRICH S,LANG H.Neoadjuvant chemotherapy or primary surgery for colorectal liver metastases［J］.Chirurg,2014,85(1):17-23.
［8］OKI E,ANDO K,NAKANISHI R,et al.Recent advances in treatment for colorectal liver metastasis ［J］.Ann Gastroenterol Surg,2018,2(3):167-175.
［9］VAN CUTSEM E,CERVANTES A,NORDLINGER B,et al.Metastatic colorectal cancer:ESMO clinical practice guidelines for diagnosis,treatment and follow-up［J］.Ann Oncol,2014,25:1-9.
［10］TABERMERO J,VAN CUTSEM E,LAKOMY R,et al.Aflflibercept versus placebo in combination with flfluorouracil,leucovorin and irinotecan in the treatment of previously treated metastatic colorectal cancer:prespecifified subgroup analyses from the VELOUR trial［J］.Eur J Cancer,2014,50(2):320-331.
［11］SUTPHINPD，GANGULI S.Interventional treatment of hepatic metastases from colorectal cancer［J］.Semin Intervent Radiol,2020,37(5):492-498.
［12］王宁,高云飞,王兴海,等. 125I粒子植入治疗直结肠癌肝转移［J］.中国老年学杂志,2020,40(22):4746-4749. WANG N,GAO YF,WANG XH,et al. 125 I particle implantation for the treatment of rectal colon cancer liver metastases［J］.Chinese Journal of Gerontology,2020,40(22):4746-4749.
［13］T KISHIKI,K KUCHTA,H MATSUOKA,et al.The impact of tumor location on the biological and oncologiea I differences of colon cancer:Multi-institutional propensity score - matched study［J］.Am J Surg,2019,217(1):46-52.
［14］DOLATKHAH R，DASTGIRI S，EFTEKHAR SADAT AT，et al.Impact of RAS/RAF mutations on clinical and prognostic outcomes in metastatic colorectal cancer［J］.Bioimpacts,2021,11(1):5-14.
［15］GUO TA,WU YC,TAN C,et al.Clinicopathologic features and prognostic value of KRAS,NRAS and BRAF mutations and DNA mismatch repair status: A single-center retrospective study of 1834 Chinese patients with Stage Ⅰ-Ⅳ colorectal cancer［J］.Int J Cancer,2019,145(1):1625-1634.
［16］陈海霞，何亚楠，王维娜，等.结直肠癌组织中KRAS和BRAF基因突变与临床病理特征及预后的关系［J］.现代肿瘤医学，2021，29（4）：626-631. CHEN HX,HE YN,WANG WN,et al.Relationship between KRAS and BRAF gene mutations and clinicopathology and prognosis in colorectal cancer tissues［J］.Modern Oncology，2021，29（4）：626-631.
［17］李慧馨,卢实春,杨占宇，等.KRAS基因突变对结直肠癌肝转移患者长期预后的影响及临床相关因素研究［J］.中华肝胆外科杂志,2020,26(5):326-329. LI HX,LU SC,YANG ZY,et al.Study on the effect of KRAS gene mutation on the long-term prognosis of patients with liver metastasis from colorectal cancer and clinical related factors［J］.Chinese Journal of Hepatobiliary Surgery,2020,26(5):326-329.
［18］WEI S,LI C,LI M,et al.Radioactive Iodine-125 in tumor therapy:Advances and future directions［J］.Front Oncol,2021,11:717180.

Memo

Memo:
辽宁省民生科技计划联合计划项目(编号：2021JH2/10300098)
Last Update: 2024-01-30