Fiorentini Giammaria, Carandina Riccardo, Sarti Donatella, Nardella Michele, Zoras Odysseas, Guadagni Stefano, Inchingolo Riccardo, Nestola Massimiliano, Felicioli Alessandro, Barnes Navarro Daniel, Munoz Gomez Fernando, Aliberti Camillo
Onco-Hematology Department, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", 61122 Pesaro, Italy.
Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research and Treatment of Cancer, 35128 Padova, Italy.
World J Gastrointest Oncol. 2017 Sep 15;9(9):379-384. doi: 10.4251/wjgo.v9.i9.379.
To study tumor response, and tolerability of arterially directed embolic therapy (ADET) with polyethylene glycol embolics loaded with irinotecan for the treatment of colorectal cancer liver metastases (CRC-LM). Secondary objectives were to monitor quality of life, time to progression and survival of patients.
Patients were included in the study if they were affected by CRC-LM, refractory to systemic chemotherapy, treated with ADET using polyethylene glycol embolics, and had liver involvement < 50%. Tumor response, performance status (PS), tumor marker antigens, and quality of life (QoL) were monitored at 1, 3 and 6 mo after ADET. QoL was assessed with the Palliative Performance Scale (PPS).
We treated 50 consecutive CRC-LM patients with ADET using polyethylene glycol embolics. Their tumor response one month after ADET was: 28% of complete response (CR), 48% of partial response (PR), 8% stable disease (SD), and 16% of progression. Tumor response 3 mo after ADET was CR 24%, PR 38%, SD 19% and progression disease (PD) 19%. Tumor response 6 mo after ADET was CR 18%, PR 44%, SD 21% and PD 18%. QoL was 90% PPS at each time point. Median time to progression for patients who progressed was 2.5 mo (range 0.8-6). Median follow-up was 14 mo (0.8-25 range). ADETs were performed with no complications. Observed side effects (mild or moderate intensity) were: Pain in 32% of patients, increase of transaminase levels in 20% and fever in 14%, whereas 30% of patients did not complain any adverse event.
The treatment of unresectable CRC-LM with ADET using polyethylene glycol microspheres loaded with irinotecan was effective in tumor response and resulted in mild toxicity, and good QoL.
研究载有伊立替康的聚乙二醇栓塞剂动脉内定向栓塞治疗（ADET）对结直肠癌肝转移（CRC-LM）的肿瘤反应及耐受性。次要目标是监测患者的生活质量、疾病进展时间和生存期。
纳入受CRC-LM影响、对全身化疗耐药、接受聚乙二醇栓塞剂ADET治疗且肝脏受累<50%的患者。在ADET后1、3和6个月监测肿瘤反应、体能状态（PS）、肿瘤标志物抗原和生活质量（QoL）。使用姑息治疗表现量表（PPS）评估QoL。
我们连续用聚乙二醇栓塞剂对50例CRC-LM患者进行了ADET治疗。ADET后1个月时，他们的肿瘤反应为：28%完全缓解（CR），48%部分缓解（PR），8%疾病稳定（SD），16%疾病进展。ADET后3个月时，肿瘤反应为CR 24%，PR 38%，SD 19%，疾病进展（PD）19%。ADET后6个月时，肿瘤反应为CR 18%，PR 44%，SD 21%，PD 18%。各时间点QoL为90%PPS。进展患者的中位疾病进展时间为2.5个月（范围0.8 - 6）。中位随访时间为14个月（范围0.8 - 25）。进行ADET无并发症。观察到的副作用（轻度或中度强度）为：32%的患者疼痛，20%转氨酶水平升高，14%发热，而30%的患者未抱怨任何不良事件。
使用载有伊立替康的聚乙二醇微球的ADET治疗不可切除的CRC-LM在肿瘤反应方面有效，毒性轻微，生活质量良好。
