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Selective Internal Radiation Therapy (SIRT), also known as radioembolisation, is a minimal invasive, endovascular treatment for primary and secondary liver tumours. In France, SIR-Spheres are listed as reimbursable by the national health authorities (Haute Autorité de Santé [HAS]). In order to evaluate the reimbursement after five years, all patients treated with SIR-Spheres will be entered into a registry that collects data on the real-life clinical application of SIRT and reports to the national authorities.
Selective internal radiation therapy (SIRT), also called radioembolisation (RE), with SIR-Spheres microspheres is an endovascular procedure, included within the interventional oncologic technologies to treat primary and secondary liver tumours. Using a microcatheter, a precise dose of resin microspheres is released in the hepatic artery, where they are carried into the arterioles and selectively lodge in the tumour microvasculature. The microspheres are loaded with the radioactive yttrium-90, a high-energy beta-emitting isotope with a half-life of 64.1 hours. Following administration, 94% of the radiation is delivered in 11 days.
In France, SIR-Spheres are listed as reimbursable by the national health authorities (Haute Autorité de Santé [HAS]). In order to evaluate the reimbursement after five years, all patients treated with SIR-Spheres will be entered into a registry that collects data on the real-life clinical application of SIRT and reports to the national authorities.
The goal of the research project is to gain a better understanding of the real-life clinical application of radioembolisation with SIR-Spheres and the impact of the treatment in clinical practice. Secondary objectives will be to assess the observed treatment outcomes of SIRT with SIR-Spheres Y-90 resin microspheres in terms of safety, effectiveness, quality of life, technical considerations and diagnosis and treatment-related considerations.
To better understand the palliative aspect of the treatment, acquisition of the change in quality of life is included by means of EORTC's validated quality of life questionnaire QLQ C30 with accompanying HCC module to measure quality of life in patients with hepatocellular carcinoma.
Besides data collection on the initial treatment, it will be advised to collect follow-up data and quality of life data every three months for a minimum of 24 months after treatment.
CIRT-FR is a post-market, prospective, non-randomized, observational study. Patients are only asked to be enrolled when they are treated with SIR-Spheres microspheres as part of their treatment determined by the treating clinician. In no way will participation of the patient in the registry impact their treatment plan, or influence the quality of the treatment.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Yttrium-90 loaded SIR-Spheres microspheres | Device | Selective internal radiation therapy (SIRT), also called radioembolisation (RE), with SIR-Spheres microspheres is an endovascular procedure, included within the interventional oncologic technologies to treat primary and secondary liver tumours. Using a microcatheter, a precise dose of resin microspheres is released in the hepatic artery, where they are carried into the arterioles and selectively lodge in the tumour microvasculature. The microspheres are loaded with the radioactive yttrium-90, a high-energy beta-emitting isotope with a half-life of 64.1 hours. SIR-Spheres microspheres are manufactured by Sirtex Medical. | ||
| QLQ-C30 with HCC module | Behavioral | In order to measure the palliative aspect of RE with SIR-Spheres microspheres, CIRT-FR will incorporate a quality-of-life questionnaire. CIRT-FR will be using EORTC's QLQ-C30 with HCC Module to measure changes in the quality of life of the patient. The quality-of-life questionnaire will be offered to the patient before the treatment, shortly after the treatment (as soon as possible) and at every follow-up. Filling out the quality-of-life questionnaire is entirely voluntary for the patient |
| Measure | Description | Time Frame |
|---|---|---|
| Description of the clinical context in which SIR-Spheres are applied | Context of systemic therapy; intention of treatment; prior hepatic procedures; post hepatic procedures | Baseline, follow-up every 3 months until 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse events, treatment complications and laboratory assessments | Adverse events measured according to CTCAE 4.03, treatment complications reported bz investigators and abnormal laboratory assessments according to CTCAE 4.03 | Follow-up every 3 months until 24 months |
| Effectiveness |
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Inclusion Criteria:
Exclusion Criteria:
- Consent denied
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In a general manner and according to the Intent-To-Treat principle, no subject will be excluded from the analysis. The primary and secondary endpoint analysis will include all enrolled subjects in CIRT-FR.
However, patients who are considered for SIR-Spheres treatment but for whom it was decided that they would not be treated will not be included in the analysis.
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| Name | Affiliation | Role |
|---|---|---|
| Valérie I Vilgrain, Prof | Cardiovascular and Interventional Radiological Society of Europe | Study Chair |
| Thomas I Helmberger, Prof | Cardiovascular and Interventional Radiological Society of Europe | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU d'Angers | Angers | France | ||||
| CHU de Bordeaux |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39809885 | Result | Ronot M, Loffroy R, Arnold D, Greget M, Sengel C, Pinaquy JB, Pellerin O, Maleux G, Peynircioglu B, Pelage JP, Schaefer N, Sangro B, de Jong N, Zeka B, Urdaniz M, Helmberger T, Vilgrain V. Transarterial Radioembolisation with Y90 Resin Microspheres and the Effect of Reimbursement Criteria in France: Final Results of the CIRT-FR Prospective Observational Study. Cardiovasc Intervent Radiol. 2025 Feb;48(2):205-220. doi: 10.1007/s00270-024-03955-y. Epub 2025 Jan 14. | |
| 32975600 |
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| ID | Term |
|---|---|
| D008113 | Liver Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
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Based on overall survival (OS), progression free survival (PFS), liver specific PFS |
| Follow-up every 3 months until 24 months |
| QLQ-C30 | Quality of life using QLQ-C30 from baseline until 24 months | Every 3 months until 24 months |
| Technical considerations | Assessed by patient related characteristics, treatment related characteristics, treatment administration and procedure-related outcomes | Baseline |
| Diagnosis- and treatment-related considerations | Assessed by type of liver cancer, intention of the treatment, prior hepatic procedures, associated systemic therapy and post-SIRT hepatic procedures | Baseline |
| Bordeaux |
| France |
| Hôpital Beaujon | Clichy | France |
| Hôpital Henri Mondor | Créteil | France |
| Chu de Dijon | Dijon | France |
| CHU de Grenoble Alpes | Grenoble | France |
| Centre Léon Bérard | Lyon | France |
| CHU de Lyon | Lyon | France |
| Institut Paoli-Calmettes | Marseille | France |
| CHU de Nimes | Nîmes | France |
| Institut Gustave Roussy | Paris | France |
| CHU de Poitiers | Poitiers | France |
| CHRU de Strasbourg | Strasbourg | France |
| Result |
| Loffroy R, Ronot M, Greget M, Bouvier A, Mastier C, Sengel C, Tselikas L, Arnold D, Maleux G, Pelage JP, Pellerin O, Peynircioglu B, Sangro B, Schaefer N, Urdaniz M, Kaufmann N, Bilbao JI, Helmberger T, Vilgrain V; CIRT-FR Principal Investigators. Short-term Safety and Quality of Life Outcomes Following Radioembolization in Primary and Secondary Liver Tumours: a Multi-centre Analysis of 200 Patients in France. Cardiovasc Intervent Radiol. 2021 Jan;44(1):36-49. doi: 10.1007/s00270-020-02643-x. Epub 2020 Sep 25. |
| 38321223 | Result | Reimer P, Vilgrain V, Arnold D, Balli T, Golfieri R, Loffroy R, Mosconi C, Ronot M, Sengel C, Schaefer N, Maleux G, Munneke G, Peynircioglu B, Sangro B, Kaufmann N, Urdaniz M, Pereira H, de Jong N, Helmberger T. Factors Impacting Survival After Transarterial Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: A Combined Analysis of the Prospective CIRT Studies. Cardiovasc Intervent Radiol. 2024 Mar;47(3):310-324. doi: 10.1007/s00270-023-03657-x. Epub 2024 Feb 6. |
| Result | Authors: Thomas Helmberger, Dirk Arnold, Romaric Loffroy, Maxime Ronot, Bruno Sangro, Frank Kolligs, Olivier Pellerin, Geert Maleux, Bora Peynircioglu, Niklaus Schaefer, Jose Ignacio Bilbao, Niels de Jong, Milan Geyer, Bleranda Zeka, Maria Urdaniz, Valerie Vilgrain Article Title: Hepatocellular carcinoma patients treated with TARE monotherapy or combination therapy with curative intent: a retrospective, exploratory analysis of two European prospective studies Journal Name: CVIR Oncology Publication Date: 2026 Volume number: 2:5 |
| D008107 |
| Liver Diseases |