Background: To compare outcomes for patients with colorectal cancer liver metastases (CRCLM) treated by drug-eluting bead chemoembolization (DEB-TACE) or radioembolization (TARE). Patients and Methods: A singlecenter retrospective review was carried out on 202 patients with CRCLM, treated by or TARE (n=155) patients. Propensity-matching yielded 44 pairs. Paired statistical analysis was performed on matched pair demographics, treatment response, and survival. Results: Patients treated with DEB-TACE had worse extra-hepatic metastasis (68.1 vs. 47.7%, p=0.014) and ≥10 liver lesions (42.2 vs. 68.8%, p=0.001). Matched patients treated with DEB-TACE had a trend towards worse toxicity (27% vs. 9.1% (p=0.057). Index DEB-TACE treatment was not a prognostic factor for overall survival (hazard ratio=0.94, 95% confidence intervaI=0.54-1.65; p=0.83). Conclusion: In the matched CRCLM cohort, there was a trend towards worse toxicity post-DEB-TACE treatment, but it was not an independent prognostic factor for survival.Metastatic colon cancer is one of the leading causes for colon cancer-driven morbidity and mortality (1). Treatment for colorectal cancer liver metastases (CRCLM) includes hepatectomy with curative intent along with systemic chemotherapy and biological agents (such as bevacizumab, or cetuximab) (1). Treatment can become more challenging for patients who are not candidates for surgery or who have failed multiple lines of systemic therapy.Transarterial liver therapy can be used to mitigate liver disease and has been shown to achieve good tumor response and disease control in large cohorts (2, 3). Transarterial radioembolization (TARE) involves the infusion of glass (Theraspere; BTG Company), London, UK) or resin (SirSpheres, Sirtex, North Sydney, NSW, Australia) microspheres carrying yttrium-90, a radioactive element that emits pure beta-particle radiation, into liver tumors through their hepatic arterial feeding vessels (4). Chemoembolization (TACE) is another treatment modality that shuts down tumor blood flow, promotes necrosis, and releases chemotherapy (5). TACE with drug-eluting beads (DEB-TACE) has been developed to optimize chemotherapy and embolic particle delivery including via delivery of calibrated bead size and longer sustained chemotherapy release (3).While there are clinical studies suggesting that TARE and DEB-TACE separately have treatment effectiveness against CRCLM (6-15), there are very limited studies comparing TARE and DEB-TACE toxicity and treatment response in patients with CRCLM (16,17). This study compared the treatment response, toxicity, and survival for patients with CRCLM treated with DEB-TACE or TARE.
Patients and MethodsThe study protocol conformed to the 1975 Declaration of Helsinki ethical guidelines and had Institutional Review Board approval (IRB ID#: 201608028). The study was a retrospective analysis of singleinstitution patients who underwent transarterial treatment for CRCLM. Key demographics included age, gender, sex, weight, baseline medical history (cardiac, vascular, pulm...