Transarterial chemoembolization for patients with metastatic uveal melanoma in the liver

Abstract

Objective: to evaluate the safety and efficacy of transarterial chemoembolization method (TACE) in the treatment of inoperable patients with uveal melanoma with isolated liver metastases with cured the primary focus. Material and methods. In N.N. Blokhin RCRC since 2000, 31 patients received treatment with metastatic uveal melanoma in the liver. Among them: men – 13 (42%), women – 18 (58%). The average age of 45.12 ± 13.22 years, range 23–71 years. Time detection of liver metastases after treatment of the primary tumor ranged from 2 to 180 months, median – 23 months. Liver lesion volume to 25% was in 11 patients, to 50% in 13, to 75% in 7 patients. Total 62 TACE intervention was performed. As used embolizing materials: Lipiodol 10 ml in 45 cases, microspheres – in 11 cases (particle sizes ranged from 100 to 500 microns), combinations presented embolizing materials have been used in 6 patients. As the chemotherapy Doxorubicin performed at a dosage of 100 mg, or Gemzar 1–2 g, or Carboplatin 450 mg. Results. 100% of the TACE was technically successful. Complications related to the technical implementation not observed. Local response was observed in 21 (67.7%) patients with metastatic uveal melanoma. Duration of monitoring of patients after TACE was held from 2 to 60 months. Median follow-up in this case was 10 months. Overall survival in this group of patients was calculated by Kaplan–Meier. 1-year was 51.0 ± 9.5%, 2-year 34.0 ± 15.2%. The median survival – 12.9 months. 20 patients were alive at the time of the study, 11 died from progression. Conclusion. In this study transarterial chemoembolization in patients with metastatic uveal melanoma in the liver has established itself as an effective and well-tolerated treatment. Objective response or stabilization process in the liver was observed in 68% of patients. A median overall survival was comparable to that provided in the literature.