Selective internal radiotherapy (SIR!) is a liver-directed treatment involving the injection of yttrium-90 microspheres into the blood supply of liver tumours* There are very few studies assessing health-related quality of life (HRQOL) in patients treated with SiRT. Patients with liver métastasés from colorectal cancer (CRC) were randomised in the FOXFIRE (FFr; ISRCTN83867919), SIRFLOX (SF; NCT00724503) and FOXFIRE-Global (FFrG; NCT01721954) trials of first-line oxaliplatin-fluorouracil (FOLFOX) chemotherapy combined with SIRT versus FOLFOX alone. HRQOL was assessed using the three-level EQ-5D, European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) and EORTC Colorectal Liver Métastasés cancer module (EORTC QLQ-LMC21) at baseline, as3 months, 6 months, 12 months and annually thereafter from randomisation, and at disease progression. Analyses were conducted on an intention-to-treat basis. In total, 554 patients were randomised to SIRT + FOLFOX and 549 patients to FOLFOX alone. HRQOL was statistically significant lower in SIRT + FOLFOX patients s3 months after SIRT administration in all three instruments, particularly global health, physical and role functioning and symptoms of fatigue, nausea/vomiting and appetite loss. By accepted thresholds, these differences were deemed not clinically important Differences between SIRT + FOLFOX and FOLFOX alone over the 2-year follow up and at disease progression were also not clinically important Although there is some decrease in HRQOL for up to 3 months following SIRT, the addition of SiRT to FOLFOX chemotherapy does not change HRQOL to a clinically important degree in metastatic CRC patients.
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