Thirty patients were treated at three Australian cancer centers with selective internal radiation (SIR) spheres for liver metastases from colorectal cancer. All patients had previously had their cancer progress on 5FU (fluorouracil) treatment. At the time, neither oxaliplatin nor irinotecan was available as reimbursible treatment in Australia, but 73% of patients had previously received either oxaliplatin or irinotecan treatments and gotten worse.
Twenty-nine (29) patients were evaluated for safety and effectiveness of the SIR-spheres treatment. There were 10 partial responses (33%) that were greater than 30% decrease in tumor size. The median duration of response to treatment was 8.3 months, with a median time to progression of cancer of 5.3 months. However, among patients who had a partial response to therapy, time to progression was 9.2 months.
Some responses continued to progress over time, with one patient having a complete response (disappearance of all target lesions) at 6 months.
Fourteen (14) patients had already received all available chemotherapy treatments, but there was a lower rate of response among this group (21%) and a shorter time to disease progression (3.9 months.) No patients with a poor performance status score or who had cancer outside the liver showed a response to treatment.
Toxicity was acceptable, although there were 4 cases of late gastric ulceration. Most side effects were mild and included nausea, loss of appetite, lethargy, or abdominal pain.
The research team, headed by Lionel C. Lim, concluded,
In patients with metastatic colorectal cancer that have previously received treatment with 5-FU based chemotherapy, treatment with SIR-spheres has demonstrated encouraging activity. Further studies are required to better define the subsets of patients most likely to respond
Their results were published in [*BMC Cancer*, Volume 5](http://www.biomedcentral.com/1471-2407/5/132/abstract)