Transarterial treatment of colorectal cancer liver metastatic disease with microspheres preloaded with chemotherapeutic agents.

Doctoral Dissertation uoadl:2778770 411 Read counter

Unit:
Τομέας Κλινικοεργαστηριακός
Library of the School of Health Sciences
Deposit date:
2018-07-17
Year:
2018
Author:
Vergadis Chrysovalantis
Dissertation committee:
Ηλίας Μπρούντζος, Καθηγητής, Ιατρική, ΕΚΠΑ
Ευσταθόπουλος Ευστάθιος, Καθηγητής, Ιατρική, ΕΚΠΑ
Μαλαγάρη Αικατερίνη, Αναπλ. καθηγήτρια, Ιατρική, ΕΚΠΑ
Αλεξοπούλου Ευθυμία, Αναπλ. καθηγήτρια, Ιατρική, ΕΚΠΑ
Παπαθανασίου Ματθίλδη, Επίκ. καθηγήτρια, Ιατρική, ΕΚΠΑ
Κουρέας Ανδρέας, Επίκ. καθηγητής, Ιατρική, ΕΚΠΑ
Σπηλιόπουλος Σταύρος, Επίκ. καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Διακαθετηριακή θεραπεία μεταστατικού καρκίνου του ήπατος με σφαιρίδια που απελευθερώνουν χημειοθεραπευτικά
Languages:
Greek
Translated title:
Transarterial treatment of colorectal cancer liver metastatic disease with microspheres preloaded with chemotherapeutic agents.
Summary:
Background: Transarterial chemoembolization (TACE) has been investigated in patients with colorectal cancer liver metastases (CCLM). Limited experience and available data suggest that TACE can achieve disease stabilization or improvement, even in heavily pretreated patients
Purpose: This prospective study evaluated the safety and effectiveness of TACE using irinotecan loaded microspheres for treatment of unrecectable CCLM in a salvage setting of patients.
Patients and Methods:. Patients with liver dominant metastatic colorectal cancer, who failed at least 1 line of systemic chemotherapy, were treated with chemoembolizations with microspheres (Hepasphere® MeritMedical ) preloaded with irinotecan. Beads were delivered selectively into hepatic segmental or lobar arteries. Response was evaluated following modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier method was used to evaluate hepatic progression free survival (PFS) and overall survival (OS). The adverse events of the TACE also reviewed. All patients had died at time of analysis.
Results: 76 patients (mean age: 69 y.o) were treated with TACE using microspheres preloaded with irinotecan. A total of 227 TACE procedures were performed. All TACE procedures were performed successfully. 5 major complications occurred including 4 patients developed liver failure and 1 patient with liver abscess after TACE. Modified RECIST objective response rate (ORR) were 64.5 %. Median overall survival after first TACE was 10.8 months and Progression free survival (PFS) was 5.8 months. Median OS and PFS was longer in patients with limited or oligometastatic liver disease compared with extensive intrahepatic disease (p<0.005).
Conclusions: Our data suggest that TACE using irinotecan loaded microspheres is safe and effective treatment in terms of local responce and progression free survival. Overall survival benefit in a salvage setting seems to be limited in patients with advanced intrahepatic tumor load.
Main subject category:
Health Sciences
Keywords:
Transarterial chemoembolization, Colorectal cancer liver metastases, Survival, Objective responce, Irinotecan
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
108
Number of pages:
118
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