Yttrium-90 microsphere brachytherapy for liver metastases from uveal melanoma clinical outcomes and the predictive value of fluorodeoxyglucose positron emission tomography

Harriet Eldredge-Hindy, Nitin Ohri, Pramila R. Anne, David Eschelman, Carin Gonsalves, Charles Intenzo, Voichita Bar-Ad, Adam Dicker, Laura Doyle, Jun Li, Takami Sato

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives: To report outcomes after yttrium-90 microsphere brachytherapy for unresectable liver metastases from uveal melanoma and to evaluate factors predictive for overall survival (OS) and hepatic progression-free survival (PFS). Methods: A total of 71 patients were consecutively treated with microsphere brachytherapy for unresectable liver metastases from uveal melanoma between 2007 and 2012. Clinical, radiographic, and positron emission tomography-derived, functional tumor parameters were evaluated by log-rank test in univariate analysis and backwards stepwise multivariate Cox proportional hazards regression. OS and hepatic PFS were estimated by Kaplan-Meier analysis. Results: A total of 134 procedures were performed in 71 patients with a median age of 63 years (range, 23 to 91 y). Fifty-eight patients (82%) received microsphere brachytherapy as a salvage therapy. Median hepatic PFS and OS after microsphere brachytherapy were 5.9 months (range, 1.3 to 19.1 mo) and 12.3 months (range, 1.9 to 49.3 mo), respectively. Median OS times after diagnosis of liver metastases was 23.9 months (range, 6.2 to 69.0 mo). In univariate analysis, female sex, pretreatment metabolic tumor volume, and total glycolic activity (TGA) were significantly correlated with hepatic PFS and OS. In multivariate analysis, female sex and TGA retained significance as independent predictors of hepatic PFS and OS. A low pretreatment TGA (<225 g) was associated with a significantly longer median OS than was a TGAZ225 g (17.2 vs. 9.7 mo, P = 0.01). Conclusions: Yttrium-90 microsphere brachytherapy provided favorable survival times in patients with unresectable liver metastases from uveal melanoma. Metabolic tumor volume and TGA are predictive functional tumor parameters, which may aid patient selection and risk stratification.

Original languageEnglish (US)
Pages (from-to)189-195
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume39
Issue number2
DOIs
StatePublished - 2016
Externally publishedYes

Fingerprint

Yttrium
Brachytherapy
Microspheres
Positron-Emission Tomography
Neoplasm Metastasis
Liver
Survival
Disease-Free Survival
Tumor Burden
Uveal melanoma
Salvage Therapy
Kaplan-Meier Estimate
Patient Selection
Neoplasms
Multivariate Analysis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Yttrium-90 microsphere brachytherapy for liver metastases from uveal melanoma clinical outcomes and the predictive value of fluorodeoxyglucose positron emission tomography. / Eldredge-Hindy, Harriet; Ohri, Nitin; Anne, Pramila R.; Eschelman, David; Gonsalves, Carin; Intenzo, Charles; Bar-Ad, Voichita; Dicker, Adam; Doyle, Laura; Li, Jun; Sato, Takami.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 39, No. 2, 2016, p. 189-195.

Research output: Contribution to journalArticle

Eldredge-Hindy, Harriet ; Ohri, Nitin ; Anne, Pramila R. ; Eschelman, David ; Gonsalves, Carin ; Intenzo, Charles ; Bar-Ad, Voichita ; Dicker, Adam ; Doyle, Laura ; Li, Jun ; Sato, Takami. / Yttrium-90 microsphere brachytherapy for liver metastases from uveal melanoma clinical outcomes and the predictive value of fluorodeoxyglucose positron emission tomography. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2016 ; Vol. 39, No. 2. pp. 189-195.
@article{b5b5d57f5df646a7883a5119b4674600,
title = "Yttrium-90 microsphere brachytherapy for liver metastases from uveal melanoma clinical outcomes and the predictive value of fluorodeoxyglucose positron emission tomography",
abstract = "Objectives: To report outcomes after yttrium-90 microsphere brachytherapy for unresectable liver metastases from uveal melanoma and to evaluate factors predictive for overall survival (OS) and hepatic progression-free survival (PFS). Methods: A total of 71 patients were consecutively treated with microsphere brachytherapy for unresectable liver metastases from uveal melanoma between 2007 and 2012. Clinical, radiographic, and positron emission tomography-derived, functional tumor parameters were evaluated by log-rank test in univariate analysis and backwards stepwise multivariate Cox proportional hazards regression. OS and hepatic PFS were estimated by Kaplan-Meier analysis. Results: A total of 134 procedures were performed in 71 patients with a median age of 63 years (range, 23 to 91 y). Fifty-eight patients (82{\%}) received microsphere brachytherapy as a salvage therapy. Median hepatic PFS and OS after microsphere brachytherapy were 5.9 months (range, 1.3 to 19.1 mo) and 12.3 months (range, 1.9 to 49.3 mo), respectively. Median OS times after diagnosis of liver metastases was 23.9 months (range, 6.2 to 69.0 mo). In univariate analysis, female sex, pretreatment metabolic tumor volume, and total glycolic activity (TGA) were significantly correlated with hepatic PFS and OS. In multivariate analysis, female sex and TGA retained significance as independent predictors of hepatic PFS and OS. A low pretreatment TGA (<225 g) was associated with a significantly longer median OS than was a TGAZ225 g (17.2 vs. 9.7 mo, P = 0.01). Conclusions: Yttrium-90 microsphere brachytherapy provided favorable survival times in patients with unresectable liver metastases from uveal melanoma. Metabolic tumor volume and TGA are predictive functional tumor parameters, which may aid patient selection and risk stratification.",
author = "Harriet Eldredge-Hindy and Nitin Ohri and Anne, {Pramila R.} and David Eschelman and Carin Gonsalves and Charles Intenzo and Voichita Bar-Ad and Adam Dicker and Laura Doyle and Jun Li and Takami Sato",
year = "2016",
doi = "10.1097/COC.0000000000000033",
language = "English (US)",
volume = "39",
pages = "189--195",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Yttrium-90 microsphere brachytherapy for liver metastases from uveal melanoma clinical outcomes and the predictive value of fluorodeoxyglucose positron emission tomography

AU - Eldredge-Hindy, Harriet

AU - Ohri, Nitin

AU - Anne, Pramila R.

AU - Eschelman, David

AU - Gonsalves, Carin

AU - Intenzo, Charles

AU - Bar-Ad, Voichita

AU - Dicker, Adam

AU - Doyle, Laura

AU - Li, Jun

AU - Sato, Takami

PY - 2016

Y1 - 2016

N2 - Objectives: To report outcomes after yttrium-90 microsphere brachytherapy for unresectable liver metastases from uveal melanoma and to evaluate factors predictive for overall survival (OS) and hepatic progression-free survival (PFS). Methods: A total of 71 patients were consecutively treated with microsphere brachytherapy for unresectable liver metastases from uveal melanoma between 2007 and 2012. Clinical, radiographic, and positron emission tomography-derived, functional tumor parameters were evaluated by log-rank test in univariate analysis and backwards stepwise multivariate Cox proportional hazards regression. OS and hepatic PFS were estimated by Kaplan-Meier analysis. Results: A total of 134 procedures were performed in 71 patients with a median age of 63 years (range, 23 to 91 y). Fifty-eight patients (82%) received microsphere brachytherapy as a salvage therapy. Median hepatic PFS and OS after microsphere brachytherapy were 5.9 months (range, 1.3 to 19.1 mo) and 12.3 months (range, 1.9 to 49.3 mo), respectively. Median OS times after diagnosis of liver metastases was 23.9 months (range, 6.2 to 69.0 mo). In univariate analysis, female sex, pretreatment metabolic tumor volume, and total glycolic activity (TGA) were significantly correlated with hepatic PFS and OS. In multivariate analysis, female sex and TGA retained significance as independent predictors of hepatic PFS and OS. A low pretreatment TGA (<225 g) was associated with a significantly longer median OS than was a TGAZ225 g (17.2 vs. 9.7 mo, P = 0.01). Conclusions: Yttrium-90 microsphere brachytherapy provided favorable survival times in patients with unresectable liver metastases from uveal melanoma. Metabolic tumor volume and TGA are predictive functional tumor parameters, which may aid patient selection and risk stratification.

AB - Objectives: To report outcomes after yttrium-90 microsphere brachytherapy for unresectable liver metastases from uveal melanoma and to evaluate factors predictive for overall survival (OS) and hepatic progression-free survival (PFS). Methods: A total of 71 patients were consecutively treated with microsphere brachytherapy for unresectable liver metastases from uveal melanoma between 2007 and 2012. Clinical, radiographic, and positron emission tomography-derived, functional tumor parameters were evaluated by log-rank test in univariate analysis and backwards stepwise multivariate Cox proportional hazards regression. OS and hepatic PFS were estimated by Kaplan-Meier analysis. Results: A total of 134 procedures were performed in 71 patients with a median age of 63 years (range, 23 to 91 y). Fifty-eight patients (82%) received microsphere brachytherapy as a salvage therapy. Median hepatic PFS and OS after microsphere brachytherapy were 5.9 months (range, 1.3 to 19.1 mo) and 12.3 months (range, 1.9 to 49.3 mo), respectively. Median OS times after diagnosis of liver metastases was 23.9 months (range, 6.2 to 69.0 mo). In univariate analysis, female sex, pretreatment metabolic tumor volume, and total glycolic activity (TGA) were significantly correlated with hepatic PFS and OS. In multivariate analysis, female sex and TGA retained significance as independent predictors of hepatic PFS and OS. A low pretreatment TGA (<225 g) was associated with a significantly longer median OS than was a TGAZ225 g (17.2 vs. 9.7 mo, P = 0.01). Conclusions: Yttrium-90 microsphere brachytherapy provided favorable survival times in patients with unresectable liver metastases from uveal melanoma. Metabolic tumor volume and TGA are predictive functional tumor parameters, which may aid patient selection and risk stratification.

UR - http://www.scopus.com/inward/record.url?scp=84961938148&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84961938148&partnerID=8YFLogxK

U2 - 10.1097/COC.0000000000000033

DO - 10.1097/COC.0000000000000033

M3 - Article

C2 - 24441583

AN - SCOPUS:84961938148

VL - 39

SP - 189

EP - 195

JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

SN - 0277-3732

IS - 2

ER -