Transarterial Chemoembolisation of Colorectal Liver Metastases with Irinotecan-Loaded Beads: A Bi-institutional Analysis of 125 Treatments in 53 Patients

• Published in: Cardiovascular and interventional radiology 2019-07, Vol.42 (7), p.979-990
• Main Authors: Ngo, An, von Stempel, Conrad, Corbo, Beniamino, Bandula, Steve, Shiu, Kai Keen, Raja, Jowad, Hague, Julian, Evans, Jonathan, Kibrya, Nabil
• Format: Article
• Language: English
• Subjects: ABLATION; ALGORITHMS; Beads; Cardiology; CHEMOTHERAPY; Clinical Investigation; Imaging; Interventional Oncology; Irinotecan; LIVER; Liver cancer; Medical treatment; Medicine; Medicine & Public Health; METASTASES; Metastasis; NEOPLASMS; Nuclear Medicine; PATIENTS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; REVIEWS; Subgroups; Survival; Tumors; Ultrasound
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-019-02219-4

Purpose To retrospectively review outcomes in patients treated for colorectal liver metastases with DEBIRI. Materials and Methods A retrospective analysis of patients with CRLM treated with DEBIRI was performed between 2008 and 2017 between two tertiary centres. Outcome parameters were overall survival and hepatic progression-free survival, as well as safety. Subgroup analyses were performed to assess the impact on outcomes of hepatic tumour burden at time of treatment, the presence of extrahepatic disease, prior systemic chemotherapy and the prior administration of systemic irinotecan-containing chemotherapy. Results Fifty-three patients received 125 treatments with DEBIRI over the study period. Median age of patients was 71 (range 41–88). Patients previously received a median of 1 line of chemotherapy (range 1–5). Median number of DEBIRI treatments was 2 (range 1–6). The median survival from first treatment was 14.5 months (range 1–107). Median hepatic progression-free survival was 5 months (0–86.5 months). The presence of extrahepatic disease (seen in 45% of patients) correlated with lower OS. Prolonged OS was seen in patients who received previous ablation and systemic chemotherapy. Technical success rate was found to be 99%. Post-procedural complication rate was 6%. Conclusion Our findings add to the growing body of literature to support the safety profile of DEBIRI in the treatment of CRLM. Further studies will be necessary to help establish the optimum berth of DEBIRI in the treatment algorithm for colorectal liver metastases.