Y-90 Selective Internal Radiotherapy (SIRT) is an ablative therapy used for inoperable liver metastasis. The purpose of this investigation was to examine the impact of local control after SIRT on overall survival (OS) in oligometastatic patients. A retrospective, single-institution study identified oligometastatic patients with ≤5 non-intracranial metastases receiving unilateral or bilateral lobar Y-90 SIRT from 2009 to 2021. The primary endpoint was OS defined from Y-90 SIRT completion to the date of death or last follow-up. Local failure was classified as a progressive disease at the target lesion(s) by RECIST v1.1 criteria starting at 3 months after SIRT. With a median follow-up of 15.7 months, 33 patients were identified who had a total of 79 oligometastatic lesions treated with SIRT, with the majority histology of colorectal adenocarcinoma (n= 22). In total, 94% of patients completed the Y-90 lobectomy. Of the 79 individual lesions treated, 22 (27.8%) failed. Thirteen patients received salvage liver-directed therapy following intrahepatic failure; ten received repeat SIRT. Median OS (mOS) was 20.1 months, and 12-month OS was 68.2%. Intralesional failure was associated with worse 1 y OS (52.3% vs. 86.2%,p= 0.004). These results suggest that intralesional failure following Y-90 may be associated with inferior OS, emphasizing the importance of disease control in low-metastatic-burden patients.
钇-90选择性内放射治疗（SIRT）是一种用于不可手术肝转移灶的消融疗法。本研究旨在探讨寡转移患者接受SIRT后局部控制对总生存期的影响。通过一项回顾性单中心研究，纳入2009年至2021年间接受单叶或双叶Y-90 SIRT治疗、且非颅内转移灶≤5个的寡转移患者。主要终点为总生存期，定义为从Y-90 SIRT治疗完成至死亡或末次随访的时间。局部失败根据RECIST v1.1标准，以SIRT治疗后3个月为起点评估靶病灶进展。中位随访15.7个月期间，共纳入33例患者，其79处寡转移病灶接受SIRT治疗，其中结直肠腺癌为主要病理类型（n=22）。总体94%的患者完成Y-90肝叶放射治疗。在79处治疗病灶中，22处（27.8%）出现治疗失败。13例患者发生肝内病灶进展后接受挽救性肝定向治疗，其中10例接受重复SIRT。中位总生存期为20.1个月，12个月总生存率为68.2%。病灶内治疗失败与较差的1年总生存率相关（52.3% vs. 86.2%，p=0.004）。这些结果表明Y-90治疗后病灶内失败可能与总生存期缩短相关，强调了低转移负荷患者疾病控制的重要性。
肿瘤(癌症)患者之家