Piasecki Piotr, Wierzbicki Marek, Majewska Aleksandra, Kieda Claudine, Narloch Jerzy
Department of Interventional Radiology, Military Institute of Medicine, Warsaw, Poland.
Laboratory of Molecular Oncology and Innovative Therapies, Military Institute of Medicine, Warsaw, Poland.
Pol J Radiol. 2021 Feb 28;86:e136-e142. doi: 10.5114/pjr.2021.104056. eCollection 2021.
Transarterial chemoembolization (TACE) is currently recommended for unresectable intrahepatic tumours with no vascular invasion or metastasis to other organs. It is based on drug-eluting microspheres pre-loaded with chemotherapeutics, which are injected selectively into vessels supplying the tumour, to embolize them inducing ischaemia, and elute the drug, to induce tumour response. We present our initial experience with novel irinotecan- loaded Embocure Plus microspheres in patients with metastatic colorectal cancer tumours in the liver, and their effect on HCT-116 cell cultures in vitro.
Three consecutive male patients (median age 62 [50-76] years) with liver metastatic colorectal cancer tumours were selected. All patients had a pre-procedure contrast-enhanced computed tomography, confirming multiple metastatic liver tumours (mean tumour diameter = 42 mm; range: 14-77 mm) and periprocedural dyna-CT scans for rapid treatment results assessment. : Human colon HCT116 cancer cell line was cultured, irinotecan loaded Embocure Plus microspheres were added. Cultures were assessed after 24 hours and 72 hours of incubation in normoxia or hypoxia.
All embolizations were technically successful, and no complications were observed. Stabilization of the targeted metastatic liver tumours in all patients was noted. In vitro: Significant decrease of the growth of HTC 116 cell lines were observed in controls compared to cells treated with Embocure Plus loaded with irinotecan in normoxia and hypoxia after 48 and 72 hours. We observed a tendency for less inhibited cell proliferation in low-oxygen conditions.
TACE therapy of liver metastatic tumours shows satisfactory results and a low complication rate. Embocure Plus microspheres are safe and technically feasible for superselective chemoembolization of metastatic colorectal cancer liver tumour. Dyna-CT can be used for assessment of treatment results during repeated TACE procedures.
目前推荐经动脉化疗栓塞术(TACE)用于治疗无血管侵犯或无其他器官转移的不可切除肝内肿瘤。该技术基于预先装载化疗药物的载药微球,将其选择性注入供应肿瘤的血管,使血管栓塞从而导致缺血,并使药物洗脱以诱导肿瘤反应。我们介绍了使用新型载有伊立替康的Embocure Plus微球治疗肝转移性结直肠癌患者的初步经验,以及它们对体外HCT - 116细胞培养物的影响。
选择3例连续的男性肝转移性结直肠癌患者(中位年龄62 [50 - 76]岁)。所有患者术前均进行了对比增强计算机断层扫描,证实存在多发转移性肝肿瘤(平均肿瘤直径 = 42 mm;范围:14 - 77 mm),并在围手术期进行动态CT扫描以快速评估治疗效果。培养人结肠HCT116癌细胞系,加入载有伊立替康的Embocure Plus微球。在常氧或低氧条件下孵育24小时和72小时后对培养物进行评估。
所有栓塞术在技术上均获成功,未观察到并发症。所有患者的目标转移性肝肿瘤均实现稳定。体外:与在常氧和低氧条件下用载有伊立替康的Embocure Plus微球处理的细胞相比,对照组中HTC 116细胞系的生长在48小时和72小时后显著降低。我们观察到在低氧条件下细胞增殖受抑制的趋势较小。
肝转移性肿瘤的TACE治疗显示出令人满意的结果且并发症发生率低。Embocure Plus微球对于转移性结直肠癌肝肿瘤的超选择性化疗栓塞是安全且技术上可行的。动态CT可用于在重复TACE手术期间评估治疗效果。