Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
J Vasc Interv Radiol. 2021 Jun;32(6):853-860. doi: 10.1016/j.jvir.2020.11.011. Epub 2021 Feb 23.
To evaluate the safety and efficacy of 2 locoregional therapies (LRTs) including hepatic artery embolization (HAE) and transarterial radioembolization (TARE) in the treatment of patients with metastatic ovarian cancer to the liver.
From October 2010 to May 2019, the data of 15 consecutive patients (median age, 54 years ± 9.8; range, 35-78 years) with hepatic metastatic ovarian cancer who were treated with either HAE (n = 6; 40%) or TARE (n = 9; 60%) were reviewed. The most common histopathologic type was epithelial ovarian carcinoma (80%). The most common chemotherapy regimens used prior to embolization included carboplatin, paclitaxel, cisplatin, and bevacizumab. Patients received a mean of 4 lines ± 3 (range, 1-9) of chemotherapy. All patients with serous carcinoma were resistant to platinum at the time of embolization. Indications for embolization were progression of disease to the liver while receiving chemotherapy in 14 (93.3%) patients and palliative pain control in 1 patient.
The overall response rates at 1, 3, and 6 months were 92.4%, 85.6%, and 70%, respectively. Median overall survival from the time of LRT was 9 (95% confidence interval [CI], 4-14) months. Median local tumor progression was 6.4 months ± 5.03 (95% CI, 3.3-9.5). No grade 3-5 adverse events were detected in either group.
HAE and TARE were well tolerated in patients with metastatic ovarian cancer to the liver and possibly ensured prolonged disease control in heavily treated, predominantly in patients resistant to platinum. Larger numbers are needed to verify these data.
评估包括肝动脉栓塞术(HAE)和经动脉放射性栓塞术(TARE)在内的 2 种局部区域治疗(LRT)在治疗转移性卵巢癌肝转移患者中的安全性和疗效。
2010 年 10 月至 2019 年 5 月,回顾了 15 例连续接受 HAE(n=6;40%)或 TARE(n=9;60%)治疗的肝转移性卵巢癌患者的数据。中位年龄为 54 岁±9.8 岁(范围为 35-78 岁)。最常见的组织病理学类型为上皮性卵巢癌(80%)。栓塞前最常用的化疗方案包括卡铂、紫杉醇、顺铂和贝伐单抗。患者接受的化疗线数为 4 线±3(范围 1-9)。所有浆液性癌患者在栓塞时均对铂类耐药。栓塞的适应证为 14 例(93.3%)患者在接受化疗时疾病进展至肝脏,1 例患者为姑息性疼痛控制。
1、3、6 个月的总体缓解率分别为 92.4%、85.6%和 70%。从 LRT 开始的中位总生存时间为 9 个月(95%置信区间 [CI],4-14)。中位局部肿瘤进展时间为 6.4 个月±5.03(95%CI,3.3-9.5)。两组均未发现 3-5 级不良事件。
HAE 和 TARE 可耐受转移性卵巢癌肝转移患者,可能确保在铂类耐药的大量治疗患者中延长疾病控制。需要更大的数字来验证这些数据。