SATURDAY, Jan. 19 (HealthDay News) -- For advanced colon cancer
patients who have developed liver tumors, so-called "radioactive
beads" implanted near these tumors may extend survival nearly a
year longer than among patients on chemotherapy alone, a small new
The research, from Beaumont Hospitals in Michigan, helps advance
the understanding of how various treatment combinations for
colorectal cancer -- the third most common cancer in American men
and women -- affect how well each individual treatment works,
"I definitely think there's a lot of room for studying the associations between different types of treatments," said study author Dr. Dmitry Goldin, a radiology resident at Beaumont. "There are constantly new treatments, but they come out so fast that we don't always know the consequences or complications of the associations. We need to study the sequence, or order, of treatments."
The study is scheduled to be presented Saturday at the
International Symposium on Endovascular Therapy in Miami Beach,
Fla. It was also published in the January issue of the
Journal of Vascular and Interventional Radiology.
Goldin and his colleagues reviewed medical records from 39
patients with advanced colon cancer who underwent a procedure known
as yttrium-90 microsphere radioembolization. This nonsurgical
treatment, approved by the U.S. Food and Drug Administration,
implants tiny radioactive beads near inoperable liver tumors.
Thirty of the patients were pretreated with the drug Avastin
(bevacizumab) in periods ranging from less than three months to
more than nine months before the radioactive beads were placed.
The liver is a common site for the spread of colorectal cancer,
which, according to the U.S. Centers for Disease Control and
Prevention, is diagnosed in about 137,000 Americans and kills about
52,000 each year. Many of the liver tumors are inoperable, leaving
doctors fewer choices to help prolong patients' lives.
Avastin is commonly prescribed for colon cancer that has spread
("metastatic" cancer) because the drug hinders the growth of new
blood vessels that feed tumors.
With the yttrium-90 procedure, which has been in use at major
U.S. medical centers for more than a decade, a catheter is inserted
into a small incision near the groin and threaded through arteries
until it reaches the hepatic artery in the liver, where millions of
microbeads are released near tumor sites. These beads emit
high-dose radiation directly to cancerous cells, sparing damage to
Goldin's team found that almost 70 percent of the 17 patients
with shorter intervals -- less than three months -- since their
last Avastin dose before receiving the microbeads needed their
microbead infusion stopped early due to slow blood flow near the
tumors, a much higher number than patients whose last Avastin dose
was further in the past. This was expected, Goldin said, because
the main effect of Avastin is to cut tumors' blood supply.
Additionally, treatment with Avastin didn't increase the
survival benefit of the microbeads, which added 10 to 12 months to
patients' life spans compared to chemotherapy alone, Goldin said --
a survival of 34.5 months after the diagnosis of metastatic colon
cancer, compared with 24 months.
"If you look at those [survival] numbers, there's a promising benefit" to using microbead radiation, he said. But the cost of both treatments is high -- in the tens of thousands of dollars per patient, he noted.
Dr. Felice Schnoll-Sussman, a gastroenterologist and director of
research at the Jay Monahan Center for Gastrointestinal Health at
New York-Presbyterian Hospital/Weill Cornell Medical Center in New
York City, said the study won't change her clinical approach to
treating metastatic colon cancer. But "it's important for us to try
to tease through the different treatment recommendations and
understand how one treatment affects another," she said.
"Maybe it helps you understand timing, which is never a terrible thing," she added. "This is the art of treatment of metastatic colorectal cancer -- it's in the tweaking of the treatments."
The U.S. National Cancer Institute has more about
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