Interventional Radiology Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France.
Université Paris Descartes - Sorbonne - Paris Cité, Paris, France.
Cardiovasc Intervent Radiol. 2020 Jun;43(6):866-874. doi: 10.1007/s00270-020-02438-0. Epub 2020 Feb 26.
We investigated the clinical effects of bead size in irinotecan-loaded beads chemoembolization (DEBIRI) used for treating liver-dominant colorectal cancer.
Between March 2009 and January 2018, all consecutive patients with colorectal cancer liver metastases referred for DEBIRI at our tertiary center were included in an observational study. Patients were treated exclusively with either 100-mg irinotecan-loaded DC beads of 70-150 μm (small bead group or SB) or 100-300 μm (large bead group or LB) in diameter, in addition to systemic therapy. Liver tumor response rate at 3 months, liver and overall progression-free survival (PFS) and overall survival were estimated.
In total, 84 patients with liver-dominant progressive disease underwent 232 DEBIRI sessions. Fifty-four patients were treated in the SB group and 30 patients in the LB group. Liver progression-free rates at 3 months were 86.7% for the LB group and 79.6% for the SB group (NS). Median liver-PFS and overall PFS were, respectively, 7.15 months and 7.15 months for the LB group and 7.65 and 7.55 months for the SB group (NS). Median overall survival was 13.04 months for the LB group and 15.59 months for the SB group (p = 0.04). Specific treatment grade 3 + 4 toxicity occurrence was 5 (17%) in the LB group and 20 (37%) in the SB group.
No significant difference in patient outcome was observed between DEBIRI bead sizes of 70-150 μm and 100-300 μm. A trend toward higher treatment-specific toxicity was observed with the smaller beads.
我们研究了伊立替康载药微球化疗栓塞（DEBIRI）中载药微球粒径对治疗肝优势结直肠癌的临床效果。
2009 年 3 月至 2018 年 1 月期间，所有因肝转移灶接受 DEBIRI 治疗的结直肠癌患者在我院被纳入一项观察性研究。患者在全身治疗的基础上，仅接受 70-150μm（小粒径载药微球组或 SB 组）或 100-300μm（大粒径载药微球组或 LB 组）直径的 100mg 伊立替康载药 DC 微球治疗。评估患者 3 个月时的肝脏肿瘤缓解率、肝脏及总无进展生存期（PFS）和总生存期。
共 84 例肝优势进展性疾病患者接受了 232 次 DEBIRI 治疗。54 例患者接受 SB 组治疗，30 例患者接受 LB 组治疗。LB 组和 SB 组 3 个月时的肝脏无进展生存率分别为 86.7%和 79.6%（无统计学差异）。LB 组和 SB 组的中位肝脏 PFS 和总 PFS 分别为 7.15 个月和 7.15 个月、7.65 个月和 7.55 个月（无统计学差异）。LB 组和 SB 组的中位总生存期分别为 13.04 个月和 15.59 个月（p=0.04）。LB 组有 5 例（17%）患者发生 3+4 级特异性治疗毒性，SB 组有 20 例（37%）患者发生（p=0.05）。
70-150μm 和 100-300μm 载药微球 DEBIRI 治疗患者的预后无显著差异。较小粒径载药微球的治疗特异性毒性有增加的趋势。
