Background: Selective Internal Radiation Therapy (SIRT) is a new and effective locoregional anticancer therapy for\r\ncolorectal cancer patients with liver metastases. Markers for prediction of therapy response and prognosis are\r\nneeded for the individual management of those patients undergoing SIRT.\r\nMethods: Blood samples were prospectively and consecutively taken from 49 colorectal cancer patients with\r\nextensive hepatic metastases before, three, six, 24 and 48 h after SIRT to analyze the concentrations of\r\nnucleosomes and further laboratory parameters, and to compare them with the response to therapy regularly\r\ndetermined 3 months after therapy and with overall survival.\r\nResults: Circulating nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), carcinoembryonic antigen (CEA), Creactive\r\nprotein (CRP) and various liver markers increased already 24 h after SIRT. Pretherapeutical levels of CYFRA\r\n21-1, CEA, cancer antigen 19-9 (CA 19-9), asparate-aminotransferase (AST) and lactate dehydrogenase (LDH) as well\r\nas 24 h values of nucleosomes were significantly higher in patients suffering from disease progression (N = 35)\r\nthan in non-progressive patients (N = 14). Concerning overall survival, CEA, CA 19-9, CYFRA 21-1, CRP, LDH, AST,\r\ncholine esterase (CHE), gamma-glutamyl-transferase, alkaline phosphatase, and amylase (all 0 h, 24 h) and\r\nnucleosomes (24 h) were found to be prognostic relevant markers in univariate analyses. In multivariate Cox-\r\nRegression analysis, the best prognostic model was obtained for the combination of CRP and AST. When 24 h\r\nvalues were additionally included, nucleosomes (24 h) further improved the existing model.\r\nConclusion: Panels of biochemical markers are helpful to stratify pretherapeutically colorectal cancer patients for\r\nSIR-therapy and to early estimate the response to SIR-therapy.
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