scholarly journals Selective internal radiation therapy first-line therapy – SIRFLOX and FOXFIRE

2012 ◽  
Vol 10 (3) ◽  
pp. 12-14 ◽  
Author(s):  
Harpreet S. Wasan
Keyword(s):  
Radiation Therapy ◽  
Selective Internal Radiation Therapy ◽  
First Line ◽  
Internal Radiation ◽  
First Line Therapy ◽  
Line Therapy ◽  
Selective Internal Radiation ◽  
Internal Radiation Therapy

scholarly journals SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer

2016 ◽  
Vol 34 (15) ◽  
pp. 1723-1731 ◽  
Author(s):  
Guy A. van Hazel ◽  
Volker Heinemann ◽  
Navesh K. Sharma ◽  
Michael P.N. Findlay ◽  
Jens Ricke ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Radiation Therapy ◽  
Metastatic Colorectal Cancer ◽  
Hazard Ratio ◽  
Selective Internal Radiation Therapy ◽  
First Line ◽  
Internal Radiation ◽  
Selective Internal Radiation ◽  
Internal Radiation Therapy ◽  
Control Versus

Purpose SIRFLOX was a randomized, multicenter trial designed to assess the efficacy and safety of adding selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres to standard fluorouracil, leucovorin, and oxaliplatin (FOLFOX)–based chemotherapy in patients with previously untreated metastatic colorectal cancer. Patients and Methods Chemotherapy-naïve patients with liver metastases plus or minus limited extrahepatic metastases were randomly assigned to receive either modified FOLFOX (mFOLFOX6; control) or mFOLFOX6 plus SIRT (SIRT) plus or minus bevacizumab. The primary end point was progression-free survival (PFS) at any site as assessed by independent centralized radiology review blinded to study arm. Results Between October 2006 and April 2013, 530 patients were randomly assigned to treatment (control, 263; SIRT, 267). Median PFS at any site was 10.2 v 10.7 months in control versus SIRT (hazard ratio, 0.93; 95% CI, 0.77 to 1.12; P = .43). Median PFS in the liver by competing risk analysis was 12.6 v 20.5 months in control versus SIRT (hazard ratio, 0.69; 95% CI, 0.55 to 0.90; P = .002). Objective response rates (ORRs) at any site were similar (68.1% v 76.4% in control v SIRT; P = .113). ORR in the liver was improved with the addition of SIRT (68.8% v 78.7% in control v SIRT; P = .042). Grade ≥ 3 adverse events, including recognized SIRT-related effects, were reported in 73.4% and 85.4% of patients in control versus SIRT. Conclusion The addition of SIRT to FOLFOX-based first-line chemotherapy in patients with liver-dominant or liver-only metastatic colorectal cancer did not improve PFS at any site but significantly delayed disease progression in the liver. The safety profile was as expected and was consistent with previous studies.

scholarly journals First-Line Selective Internal Radiation Therapy in Patients with Uveal Melanoma Metastatic to the Liver

2019 ◽  
Vol 61 (3) ◽  
pp. 350-356 ◽  
Author(s):  
Alexandre Ponti ◽  
Alban Denys ◽  
Antonia Digklia ◽  
Niklaus Schaefer ◽  
Arnaud Hocquelet ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Uveal Melanoma ◽  
Selective Internal Radiation Therapy ◽  
First Line ◽  
Internal Radiation ◽  
Selective Internal Radiation ◽  
Internal Radiation Therapy

scholarly journals International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres

2021 ◽  
Author(s):  
Hugo Levillain ◽  
Oreste Bagni ◽  
Christophe M. Deroose ◽  
Arnaud Dieudonné ◽  
Silvano Gnesin ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Absorbed Dose ◽  
Steering Committee ◽  
Selective Internal Radiation Therapy ◽  
Internal Radiation ◽  
Selective Internal Radiation ◽  
Internal Radiation Therapy ◽  
Resin Microspheres ◽  
Yttrium 90 ◽  
Strong Agreement

Abstract Purpose A multidisciplinary expert panel convened to formulate state-of-the-art recommendations for optimisation of selective internal radiation therapy (SIRT) with yttrium-90 (90Y)-resin microspheres. Methods A steering committee of 23 international experts representing all participating specialties formulated recommendations for SIRT with 90Y-resin microspheres activity prescription and post-treatment dosimetry, based on literature searches and the responses to a 61-question survey that was completed by 43 leading experts (including the steering committee members). The survey was validated by the steering committee and completed anonymously. In a face-to-face meeting, the results of the survey were presented and discussed. Recommendations were derived and level of agreement defined (strong agreement ≥ 80%, moderate agreement 50%–79%, no agreement ≤ 49%). Results Forty-seven recommendations were established, including guidance such as a multidisciplinary team should define treatment strategy and therapeutic intent (strong agreement); 3D imaging with CT and an angiography with cone-beam-CT, if available, and 99mTc-MAA SPECT/CT are recommended for extrahepatic/intrahepatic deposition assessment, treatment field definition and calculation of the 90Y-resin microspheres activity needed (moderate/strong agreement). A personalised approach, using dosimetry (partition model and/or voxel-based) is recommended for activity prescription, when either whole liver or selective, non-ablative or ablative SIRT is planned (strong agreement). A mean absorbed dose to non-tumoural liver of 40 Gy or less is considered safe (strong agreement). A minimum mean target-absorbed dose to tumour of 100–120 Gy is recommended for hepatocellular carcinoma, liver metastatic colorectal cancer and cholangiocarcinoma (moderate/strong agreement). Post-SIRT imaging for treatment verification with 90Y-PET/CT is recommended (strong agreement). Post-SIRT dosimetry is also recommended (strong agreement). Conclusion Practitioners are encouraged to work towards adoption of these recommendations.

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