Division of Surgical Oncology, Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA.
Breast Cancer Res Treat. 2012 Apr;132(2):753-63. doi: 10.1007/s10549-011-1926-z. Epub 2011 Dec 27.
The purpose of this study was to evaluate the efficacy of image-guided delivery of locoregional chemotherapy to breast cancer hepatic metastases using doxorubicin-loaded drug-eluting beads (DEBDOX). An IRB-approved multi-center, prospective, open, non-controlled repeat treatment registry to investigate the safety and efficacy of doxorubicin microspheres in the treatment of patients with unresectable liver metastasis from breast cancer was reviewed. Statistical analysis was performed with differences of P < 0.05 considered significant. About 40 patients with metastatic breast cancer (MBC) to the liver underwent a total of 75 image-guided procedures with hepatic arterial drug-eluting beads loaded with doxorubicin (DEBDOX). Treatment was well tolerated with a total of eight patients sustaining 13 adverse events within the 30 days of each treatment session. All adverse events were either a grade I or grade II in toxicity. After a median follow-up of 12 months in all patients, the hepatic progression-free survival was a median of 26 months and overall survival was a median of 47 months. The treatment of hepatic metastasis from MBC using DEBDOX is an effective local therapy with very high response rates and a very safe toxicity profile. In comparison to chemotherapy alone, consideration of hepatic-directed therapy is warranted in patients with liver-dominant metastatic disease.
本研究旨在评估使用载多柔比星药物洗脱微球（DEBDOX）经图像引导局部化疗治疗乳腺癌肝转移的疗效。我们回顾了一项经机构审查委员会批准的、多中心、前瞻性、开放、非对照、重复治疗登记研究，旨在调查多柔比星微球治疗不可切除的乳腺癌肝转移患者的安全性和疗效。统计学分析采用 P<0.05 有统计学差异。共有 40 例转移性乳腺癌（MBC）肝转移患者接受了总共 75 次经图像引导的肝动脉载多柔比星药物洗脱微球（DEBDOX）治疗。治疗耐受性良好，共有 8 例患者在每次治疗后 30 天内发生了 13 例不良事件。所有不良事件的毒性均为 I 级或 II 级。所有患者的中位随访时间为 12 个月，肝无进展生存期的中位数为 26 个月，总生存期的中位数为 47 个月。DEBDOX 治疗 MBC 肝转移是一种有效的局部治疗方法，其反应率非常高，且毒性谱非常安全。与单独化疗相比，对于肝优势转移疾病的患者，有必要考虑肝定向治疗。
