Division of Vascular and Interventional Radiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Division of Vascular and Interventional Radiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
J Vasc Interv Radiol. 2023 Jun;34(6):983-990.e1. doi: 10.1016/j.jvir.2023.02.005. Epub 2023 Feb 11.
To evaluate the factors that affected overall survival and hepatic progression-free survival using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and Choi criteria in patients with colorectal liver metastases treated with transarterial chemoembolization (TACE) using irinotecan-eluting microspheres (IEMs) who failed at least 1 line of systemic chemotherapy.
A single-institution retrospective analysis was performed including patients with unresectable liver metastases from a colorectal primary malignancy and treated with IEM-TACE. Radiologic hepatic progression-free survival was measured using the RECIST 1.1 and Choi criteria.
The median patient age was 61.5 years, with 80 (67%) men. A total of 328 IEM-TACE procedures were performed during the study period. One hundred eighteen patients who failed at least 1 line of systemic chemotherapy before TACE demonstrated a median overall survival of 12.7 months. Overall survival was higher in patients who had previous primary resection (P < .05), prior ablation (P < .05), or completed the scheduled TACE treatments (P < .05) but was adversely affected by the presence of extrahepatic disease (P < .05) and larger preprocedural tumor burden (P < .01). Prior systemic chemotherapy lines (P = .98) and microsphere size (P = .34) did not affect survival. Partial radiologic response to treatment using the Choi criteria (n = 28, P < .01) correlated significantly with survival, a correlation not seen with the RECIST 1.1 measurements (n = 5, P = .13).
A partial response to treatment of unresectable colorectal liver metastases treated by TACE with IEMs measured using the Choi criteria correlated significantly with improved survival, while RECIST 1.1 measurements did not.
评估经伊立替康洗脱微球（IEM）肝动脉化疗栓塞（TACE）治疗至少一线系统化疗失败的结直肠癌肝转移患者，使用实体瘤反应评估标准 1.1（RECIST 1.1）和 Choi 标准的总生存和肝无进展生存的影响因素。
对 1 家机构进行回顾性分析，纳入不能切除的结直肠原发病灶肝转移且接受 IEM-TACE 治疗的患者。采用 RECIST 1.1 和 Choi 标准测量影像学肝无进展生存。
患者中位年龄为 61.5 岁，80 例（67%）为男性。研究期间共进行了 328 次 IEM-TACE 治疗。118 例在 TACE 前至少接受过一线系统化疗的患者，中位总生存为 12.7 个月。有既往原发灶切除（P<0.05）、既往消融（P<0.05）或完成计划 TACE 治疗（P<0.05）的患者总生存更高，但有肝外疾病（P<0.05）和更大术前肿瘤负荷（P<0.01）的患者生存情况较差。既往系统化疗线数（P=0.98）和微球大小（P=0.34）不影响生存。采用 Choi 标准评估的治疗部分反应（n=28，P<0.01）与生存显著相关，而 RECIST 1.1 测量的部分反应（n=5，P=0.13）则无相关性。
采用 Choi 标准评估的 IEM-TACE 治疗不可切除结直肠癌肝转移的部分反应与生存改善显著相关，而 RECIST 1.1 测量的部分反应则不相关。
