Abstract

Background. Transarterial chemoembolization (TACE) has been investigated in patients with liver metastases from colorectal cancer (LMCRC). Limited experience and available data suggest that TACE can achieve disease stabilization or improvement, even in heavily pretreated patients. Methods. Patients with LMCRC, ECOG 0–2, who failed at least 1 line of systemic chemotherapy, received embolizations with 2 mL of microspheres preloaded with 100 mg of irinotecan. Beads were delivered selectively into hepatic arteries. Primary endpoint was overall survival (OS), analyzed using the Kaplan-Meier method. Secondary endpoint was safety, assessed using CTCAE version 4.0. Results. 27 patients were treated using DEBIRI. Patient median age was 57 years (range was 45–82 years). The median number of total embolizations was 1.3 (range 1–3). The median OS was 5.4 months (95% CI; 1.1–22.7 months). The most reported postembolization events were nausea (8/27), vomiting (6/27), right upper quadrant pain (16/27), fatigue (9/27), and the development of ascites (6/27). 5/26 patients required hospitalization after TACE for severe pain. Hospitalization was also required for 1 case of allergic reaction and 1 case of infection. Conclusion. Our data suggest that TACE with DEBIRI could be efficacious in a palliative setting for patients with LMCRC, but they do not necessarily support routine use in clinical practice.

Highlights

  • Colorectal cancer (CRC) remains one of the leading causes of cancer-related deaths worldwide

  • We report a median overall survival (OS) of 5.4 months much lower than 22 months reported by Fiorentini et al [7, 8, 12] who looked at DEBIRI versus systemic FOLFIRI

  • In individuals who were refractory to 2-3 lines of systemic chemotherapy and had unresectable liver metastases from colorectal cancer (LMCRC) involving 3 months prior to embolization

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Summary

Introduction

Colorectal cancer (CRC) remains one of the leading causes of cancer-related deaths worldwide. In individuals with resected liver metastases, the 5-year survival rate is 25–37% and of this group 70–80% will have a relapse of which approximately half will reoccur in the liver [2, 3]. Several locoregional intervention therapies exist, aiming at further increasing survival, resectability, and quality of life. One such locoregional therapy is transarterial chemoembolization (TACE) [4]. Transarterial chemoembolization (TACE) has been investigated in patients with liver metastases from colorectal cancer (LMCRC). 5/26 patients required hospitalization after TACE for severe pain. Our data suggest that TACE with DEBIRI could be efficacious in a palliative setting for patients with LMCRC, but they do not necessarily support routine use in clinical practice

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