Transarterial chemoembolisation

Background Following failure of standard systemic chemotherapy, the role of hepatic transarterial therapy for colorectal hepatic metastasis continues to evolve as the experience with this technique matures. The aim of this study to gain a better understanding of the value of drug eluting bead therap...

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Bibliographic Details
Published in:World journal of surgical oncology 2009-11, Vol.7, p.80
Main Authors: Tomalty, Dana, Bosnjakovic, Petar, Scupchenko, Alexander, Martin, Robert CG, Padr, Radek, Rocek, Miloslav, O'Hara, Ryan, Robbins, Ken, Slauf, Frantisek, Tatum, Cliff
Format: Article
Language:English
Subjects:
Cancer
Chemotherapy
Colorectal cancer
Development and progression
Drug therapy
Health aspects
Liver cancer
Patient outcomes
Risk factors
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Summary:Background Following failure of standard systemic chemotherapy, the role of hepatic transarterial therapy for colorectal hepatic metastasis continues to evolve as the experience with this technique matures. The aim of this study to gain a better understanding of the value of drug eluting bead therapy when administered to patients with unresectable colorectal hepatic metastasis. Methods This was an open-label, multi-center, single arm study, of unresectable colorectal hepatic metastasis patients who had failed standard therapy from 10/2006-10/2008. Patients received repeat embolizations with Irinotecan loaded beads(max 100 mg per embolization) per treating physician's discretion. Results Fifty-five patients underwent 99 treatments using Irinotecan drug eluting beads. The median number of total treatments per patient was 2(range of 1-5). Median length of hospital stay was 23 hours(range 23 hours - 10 days). There were 30(30%) sessions associated with adverse reactions during or after the treatment. The median disease free and overall survival from the time of first treatment was 247 days and 343 days. Six patients(10%) were downstaged from their original disease status. Of these, four were treated with surgery and two with RFA. Neither number of liver lesions, size of liver lesions or extent of liver replacement([less than]= 25% vs >25%) were predictors of overall survival. Only the presence of extrahepatic disease(p = 0,001), extent of prior chemotherapy (failed 1.sup.st .sup.and 2.sup.nd .sup.line vs > 2 line failure)(p = 0,007) were predictors of overall survival in multivariate analysis. Conclusion Chemoembolization using Irinotecan loaded beads was safe and effective in the treatment of patients as demonstrated by a minimal complication rate and acceptable tumor response.
ISSN:1477-7819
1477-7819