Yammine Kabalan, Kamar Francois, Nasser Jason, Tayar Claude, Ghosn Marwan, Chehade Feras, Daher Jihad, Nicolas Gregory
Radiology, Clemenceau Medical Center, Beirut, LBN.
Oncology, Clemenceau Medical Center, Beirut, LBN.
Cureus. 2020 Apr 10;12(4):e7628. doi: 10.7759/cureus.7628.
We aim to provide results of the real-world experience of a single center in Lebanon on the use of radioembolization to treat liver-only or liver-dominant tumors. Methods: This retrospective review included patients who were evaluated for radioembolization between January 2015 and June 2017 and who had a lung shunt fraction of 20% or less. Tumor responses were determined using the response evaluation criteria in solid tumors (RECIST).
Of the 23 Arab patients with a median age of 64 years (range, 36-87 years), eight had hepatocellular carcinoma, four had cholangiocarcinoma, and 11 had liver-only or liver-dominant metastases from other primary cancers. Most (n=17) had multifocal lesions, and 13 had a history of branched (n=8) or main (n=5) portal vein thrombosis. When appropriate, the gastroduodenal artery and middle hepatic artery were embolized for consolidation of radiotherapy; 18 patients required arterial coil occlusion, two had their cystic artery occluded, and one developed cholecystitis, which was successfully treated with antibiotics and supportive care. Another patient developed a post-radioembolization complication-a peptic ulcer unrelated to arterial reflux of microspheres because both the gastroduodenal and right gastric arteries were occluded. The median time to progression was seven months (range, 3-36 months), and median overall survival from radioembolization was 12 months (range, 3-40 months). Tumor responses included five complete responses, 13 partial responses, one stable disease, and four cases of progressive disease. Conclusion: Performing radioembolization in a non-referral, private center in Lebanon resulted in good patient outcomes with few complications.
我们旨在提供黎巴嫩一家单一中心关于使用放射性栓塞治疗仅累及肝脏或以肝脏为主的肿瘤的真实世界经验结果。方法：这项回顾性研究纳入了2015年1月至2017年6月期间接受放射性栓塞评估且肺分流分数为20%或更低的患者。使用实体瘤疗效评价标准（RECIST）确定肿瘤反应。
23例阿拉伯患者，中位年龄64岁（范围36 - 87岁），其中8例为肝细胞癌，4例为胆管癌，11例为来自其他原发性癌症的仅累及肝脏或以肝脏为主的转移瘤。大多数（n = 17）有多发灶，13例有分支（n = 8）或主干（n = 5）门静脉血栓形成史。在适当情况下，对胃十二指肠动脉和肝中动脉进行栓塞以巩固放疗；18例患者需要动脉线圈闭塞，2例患者的胆囊动脉闭塞，1例发生胆囊炎，经抗生素和支持治疗成功治愈。另1例患者发生放射性栓塞后并发症——与微球动脉反流无关的消化性溃疡，因为胃十二指肠动脉和胃右动脉均闭塞。中位进展时间为7个月（范围3 - 36个月），放射性栓塞后的中位总生存期为12个月（范围3 - 40个月）。肿瘤反应包括5例完全缓解、13例部分缓解、1例病情稳定和4例疾病进展。结论：在黎巴嫩一家非转诊的私立中心进行放射性栓塞治疗，患者预后良好，并发症较少。
