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Factors associated with increased incidence of severe toxicities following yttrium-90 resin microspheres in the treatment of hepatic malignancies

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World Journal of Gastroenterology 2016年第10期22卷 3006-3014页

作者： John D Roberson II Andrew M Mc Donald Craig J Baden Chee Paul Lin Rojymon Jacob Omer L Burnett III School of Medicine University of Alabama at Birmingham Birmingham AL 35294-3412 United States Department of Radiation Oncology University of Alabama at Birmingham Birmingham AL 35233 United States Center for Clinical and Translational Science University of Alabama at Birmingham Birmingham AL 35205 United States

AIM: To further define variables associated with increased incidences of severe toxicities following administration of yttrium-90 (90Y) ***: Fifty-eight patients undergoing 79 treatments were retrospectively assessed for development of clinical and laboratory toxicity incidence following 90Y administration. Severe toxicity events were defined using Common Terminology Criteria for Adverse Events version 4.03 and defined as grade ≥ 3. Univariate logistic regression analyses were used to evaluate the effect of different factors on the incidence of severe toxicity events. Multicollinearity was assessed for all factors with P toxicity. Increased pre-treatment aspartate aminotransferase (AST; OR = 7.4, P = 0.025) and decreased pre-treatment hemoglobin (OR = 12.5, P = 0.025) were associated with severe albumin toxicity. Increasing pre-treatment model for end-stage liver disease (MELD) score (OR = 1.8, P = 0.033) was associated with severe total bilirubin toxicity. Colorectal adenocarcinoma histology was associated with severe alkaline phosphatase toxicity (OR = 5.4, P = 0.043).CONCLUSION: Clinicians should carefully consider pre-treatment albumin, INR, AST, hemoglobin, MELD, and colorectal histology when choosing appropriate candidates for 90Y microsphere therapy.

关键词： Yttrium-90 microspheres Liver metastases Multivariate analysis toxicity incidence Colorectal adenocarcinoma

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