Segal Cancer Centre, JGH, McGill University, Canada.
Radiology, McGill University Health Centre, Canada.
Gastroenterol Res Pract. 2015;2015:715102. doi: 10.1155/2015/715102. Epub 2015 Feb 26.
Background. Transarterial chemoembolization (TACE) has been investigated in patients with liver metastases from colorectal cancer (LMCRC). Limited experience and available data suggest that TACE can achieve disease stabilization or improvement, even in heavily pretreated patients. Methods. Patients with LMCRC, ECOG 0-2, who failed at least 1 line of systemic chemotherapy, received embolizations with 2 mL of microspheres preloaded with 100 mg of irinotecan. Beads were delivered selectively into hepatic arteries. Primary endpoint was overall survival (OS), analyzed using the Kaplan-Meier method. Secondary endpoint was safety, assessed using CTCAE version 4.0. Results. 27 patients were treated using DEBIRI. Patient median age was 57 years (range was 45-82 years). The median number of total embolizations was 1.3 (range 1-3). The median OS was 5.4 months (95% CI; 1.1-22.7 months). The most reported postembolization events were nausea (8/27), vomiting (6/27), right upper quadrant pain (16/27), fatigue (9/27), and the development of ascites (6/27). 5/26 patients required hospitalization after TACE for severe pain. Hospitalization was also required for 1 case of allergic reaction and 1 case of infection. Conclusion. Our data suggest that TACE with DEBIRI could be efficacious in a palliative setting for patients with LMCRC, but they do not necessarily support routine use in clinical practice.
经动脉化疗栓塞术(TACE)已在结直肠癌肝转移患者(LMCRC)中进行了研究。有限的经验和现有数据表明,TACE 可以实现疾病稳定或改善,即使是在经过大量预处理的患者中。方法:ECOG 0-2 的 LMCRC 患者,至少接受过一线系统化疗失败后,接受载有 100mg 伊立替康的 2ml 微球栓塞治疗。将微球选择性地输送到肝动脉中。主要终点是总生存期(OS),使用 Kaplan-Meier 方法进行分析。次要终点是使用 CTCAE 版本 4.0 评估的安全性。结果:27 例患者使用 DEBIRI 进行治疗。患者的中位年龄为 57 岁(范围为 45-82 岁)。总的栓塞次数中位数为 1.3(范围 1-3)。中位 OS 为 5.4 个月(95%CI;1.1-22.7 个月)。最常报告的栓塞后事件包括恶心(8/27)、呕吐(6/27)、右上腹疼痛(16/27)、乏力(9/27)和腹水形成(6/27)。5/26 例患者在 TACE 后因严重疼痛需要住院治疗。1 例因过敏反应和 1 例因感染也需要住院治疗。结论:我们的数据表明,DEBIRI 联合 TACE 可能对 LMCRC 患者的姑息治疗有效,但不一定支持在临床实践中常规使用。