Department of Vascular and Interventional Radiology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Anticancer Res. 2013 May;33(5):2077-83.
BACKGROUND/AIM: Dismal survival rates of metastatic colorectal cancer (mCRC) to the liver have been recorded. Transarterial chemoembolization (TACE) with irinotecan eluting beads (DEBIRI) may be a safe palliative treatment with fewer serious adverse effects (SAEs). We aimed to establish the safety and efficacy of DEBIRI TACE in the treatment of hepatic metastases from colorectal cancer (CRC).
A retrospective analysis of DEBIRI TACE was performed. Response was assessed using the m-RECIST criteria. The Common Terminology Criteria for Adverse Events (CTCAE v3.0) were used to record toxicity. Survival was estimated using Kaplan Meier analysis.
Twenty-eight patients treated with 47 DEBIRI TACE procedures were followed from September 2008 until February 2012. Twenty-two had metastases from colonic cancer and six metastases from rectal cancer; three patients (15%) had complete response, six (30%) partial response, four (20%) stable disease and disease progression was recorded in seven (35%); computer tomography (CT) scans were unavailable for eight patients. AEs included gastrointestinal and acid-base disturbances, hypertension, fever, insomnia, chest pain, pruritus, and neutropenia; five patients did not present AEs. The median time from diagnosis of liver metastases to initial DEBIRI treatment was 19.6 months. The median follow-up was 6.9 months. The median overall survival from first treatment was 13.3 months (95% confidence interval=6.8-19.8 months).
DEBIRI is a well-tolerated treatment option that can be used safely in the palliative treatment of hepatic metastases from CRC.
背景/目的：转移性结直肠癌（mCRC）肝转移的存活率一直很低。载药微球（DEBIRI）经动脉化疗栓塞（TACE）可能是一种安全的姑息性治疗方法，不良反应（SAEs）较少。我们旨在确定 DEBIRI TACE 治疗结直肠癌（CRC）肝转移的安全性和疗效。
对 DEBIRI TACE 进行回顾性分析。采用 m-RECIST 标准评估反应。采用不良事件通用术语标准（CTCAE v3.0）记录毒性。采用 Kaplan-Meier 分析估计生存情况。
2008 年 9 月至 2012 年 2 月，对 28 例接受 47 次 DEBIRI TACE 治疗的患者进行了随访。22 例患者有结肠癌转移，6 例患者有直肠癌转移；3 例（15%）患者完全缓解，6 例（30%）部分缓解，4 例（20%）疾病稳定，7 例（35%）疾病进展；8 例患者的 CT 扫描结果不可用。不良反应包括胃肠道和酸碱紊乱、高血压、发热、失眠、胸痛、瘙痒和中性粒细胞减少；5 例患者未出现不良反应。从肝转移诊断到首次 DEBIRI 治疗的中位时间为 19.6 个月。中位随访时间为 6.9 个月。首次治疗后的中位总生存期为 13.3 个月（95%置信区间=6.8-19.8 个月）。
DEBIRI 是一种耐受性良好的治疗选择，可安全用于结直肠癌肝转移的姑息性治疗。
