A Prospective Phase II Trial of Radioembolization for Treatment of Uveal Melanoma Hepatic Metastasis
| Autor: | Misung Yi, Inna Chervoneva, David J. Eschelman, Takami Sato, P. Rani Anne, Carin F. Gonsalves, Robert D. Adamo, Marlana Orloff, Anthony N. Hage, Mizue Terai |
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| Rok vydání: | 2019 |
| Předmět: |
Diagnostic Imaging
Male Uveal Neoplasms Oncology medicine.medical_specialty 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Yttrium Radioisotopes Radiology Nuclear Medicine and imaging Prospective Studies Melanoma Original Research business.industry Liver Neoplasms Neoplasms Second Primary Middle Aged medicine.disease Embolization Therapeutic Hepatic metastasis eye diseases Treatment Outcome Liver 030220 oncology & carcinogenesis Female business |
| Zdroj: | Radiology |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | BACKGROUND: Overall survival (OS) for patients with uveal melanoma (UM) hepatic metastases is extremely poor. Therefore, stabilization of hepatic metastases is essential to prolonging OS. PURPOSE: To assess the safety and effectiveness of radioembolization (RE) for treatment of UM hepatic metastases. MATERIALS AND METHODS: Enrollment for this prospective phase II trial began November 2011 and concluded January 2017. Treatment-naïve participants (group A) and participants who progressed after immunoembolization (group B) with hepatic tumor burden less than 50% underwent RE. Participants were followed for 1 month and every 3 months for acute and delayed toxicities, respectively. MRI, CT, and PET were performed every 3 months to evaluate for tumor response and extrahepatic disease. Participants were followed for at least 2 years or until death. Kaplan-Meier method and multivariable Cox proportional hazard models were used for data analysis. RESULTS: In group A, 24 participants (mean age ± standard deviation, 59 years ± 13; 13 men and 11 women) underwent unilobar (n = 7), fractionated whole-liver (n = 1), or sequential lobar (n = 16) RE. One participant was excluded from the trial. Complete response (n = 0), partial response (n = 9), or stable disease (n = 11) was achieved in 20 of 23 (87.0%; 95% confidence interval [CI]: 66.4%, 97.2%) participants. Median progression-free survival from liver metastasis was 8.1 months (95% CI: 6.4, 11.8; range, 3.3–33.7 months). Median OS was 18.5 months (95% CI: 11.3, 23.5; range, 6.5–73.7 months). In group B, 24 participants (mean age, 58 years ± 10; nine men and 15 women) underwent unilobar (n = 5) or sequential lobar (n = 19) RE. Complete response (n = 0), partial response (n = 8), or stable disease (n = 6) was achieved in 14 of 24 (58.3%; 95% CI: 36.3%, 77.9%) participants. Median progression-free survival from liver metastasis was 5.2 months (95% CI: 3.7, 9.8; range, 2.9–22.0 months). Median OS was 19.2 months (95% CI: 11.5, 24.0; range, 4.8–76.6 months). Grade 3 treatment-related toxicities included transient lymphopenia (group A, n = 1; group B, n = 1), pain (group A, n = 2) and nausea or vomiting (group A, n = 1). CONCLUSION: Radioembolization is a promising treatment for patients with uveal melanoma hepatic metastases. © RSNA, 2019 Online supplemental material is available for this article. |
| Databáze: | OpenAIRE |
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