Results of Application of Saturable Microspheres of Domestic Production in Locoregional Endovascular Treatment of Inoperable Patients with Malignant Liver Tumors

Abstract

The incidence of malignant liver tumors is steadily increasing. Most patients are considered inoperable at the time of detection of a malignant liver lesion. In general, unsatisfactory liver function, comorbidities, bilobar lesion, extrahepatic metastasis allow performing radical treatment in not more than 20 % of cases. Thus, the majority of patients are indicated for other types of treatment, including endovascular locoregional techniques. Taking into account the implementation of the federal program for state support of import substitution in Russia, the creation and production of competitive products in the field of medicine, including for endovascular surgery, becomes relevant. The aim of this article was to study the properties, tolerability and safety of domestically produced saturable microspheres and evaluate the immediate results of transarterial chemoembolization in the treatment of inoperable patients with primary and metastatic liver cancer. Within the framework of the State Scientific Program, clinical studies on the use of saturable microspheres produced in Russia were conducted. The results of treatment of 32 patients who underwent transarterial chemoembolization (TACE) with the use of domestic microspheres “Sphere-Spectrum” at the N.N. Blokhin Research Institute of Oncology from January 2020 to October 2022 were analyzed. Of these, TACE was performed in 24 patients diagnosed with HCC, 5 patients with liver metastases of neuroendocrine tumors, and 3 patients with melanoma metastases. TACE was performed using microspheres with sizes 35–40 in dry (210–240 μm in saturated) 50–60 μm in dry (300–360 μm in saturated), 25 mg or 50 mg in one vial. A total of 40 endovascular procedures were performed in all 32 patients with malignant liver tumor lesions. In 11 of them (34.3 %) a single TACE session was sufficient to achieve an objective response. Partial response was observed in 21 (65.7 %) patients, including those with bilobar metastatic liver lesion. All patients tolerated treatment satisfactorily, the desired therapeutic effect was achieved in 26 (81.2 %) cases (taking into account repeated interventions). One patient (3.1 %) diagnosed with HCC had a complication in the form of liver abscess formation.