Factors associated with increased incidence of toxicities following administration of yttrium-90 resin microspheres.

Abstract

409 Background: To further define factors associated with increased incidences of hepatic, constitutional, and gastrointestinal toxicities following administration of yttrium-90 (90Y) microspheres in a sequential cohort of heterogeneous patients. Methods: Fifty-seven patients who underwent 76 treatments were assessed for toxicity incidence following 90Y administration. Post-treatment clinical and liver function test (LFT) toxicities were assessed using Common Terminology Criteria for Adverse Events version 4.03. Binary logistic regression was used to evaluate the univariate effect of factors on toxicity incidences. A multivariate binary logistic regression model was performed for each toxicity using all factors with a p < 0.10 on univariate analysis. Results: Hepatic toxicities, including LFT toxicities, were present following 46.1% of treatments, while gastrointestinal and constitutional toxicities were present following 57.3% and 55.3%, respectively. Multivariate analyses revealed that colorectal adenocarcinoma, age at time of treatment, intraprocedural stasis, decreased Karnofsky Performance Status, increased body mass index (BMI), and decreased lung shunt were statistically significant (p < 0.05) predictors for increased incidence of toxicities most prevalent among our cohort. Increased pre-treatment laboratory values including albumin, alkaline phosphatase, total bilirubin, and white blood cells were also statistically significant predictors. Conclusions: Colorectal adenocarcinoma, declining functional status, decreased lung shunt, and increased pre-treatment laboratory values should be given more clinical attention when attempting to limit toxicities and improve the quality of life in patients following 90Y treatment. Specific constitutional, gastrointestinal, and hepatic toxicities including weakness, loss of appetite, and laboratory abnormalities are also associated with patients’ age, increased BMI, and intraprocedural stasis.