Transarterial chemoembolization in pancreatic adenocarcinoma with liver metastases: MR-based tumor response evaluation, apparent diffusion coefficient (ADC) patterns, and survival rates

Abstract

PurposeTo retrospectively investigate the effectiveness of triple drug combination transarterial chemoembolization (TACE) on local tumor response and survival in patients with liver metastases from pancreatic cancer. Also, this study will evaluate the variances in response regarding the number of metastases, assess the correlation between tumor response and the changes in the apparent diffusion coefficients (ADC) in diffusion weighted (DW) MRI. Materials and methodsOne hundred and twelve patients (58 men and 54 women; mean age 57) with malignant liver metastases from pancreatic adenocarcinoma underwent at least one session of TACE with a chemotherapeutic combination of mitomycin C, cisplatin, and gemcitabine. A size-based evaluation of tumor response (response evaluation criteria in solid tumors (RECIST)) was conducted, along with ADC values, and survival indices as related to treatment pattern. ResultsFour weeks following the end of the treatment, 78.26% of patients showed stable disease and 11.59% showed partial response. The median survival time was 19 months and for the stable disease group, 26 months. Low pretreatment ADC values showed no significant correlation to poor response to treatment (r = 0.347,p = 0.146). ConclusionThe triple drug TACE technique showed improvements in median survival times in patients with hepatic metastases from pancreatic carcinoma and helped control disease progression, whereas the number of hepatic lesions was not a statistically significant factor in patients' response to TACE. The data suggest that pre-treatment ADC values in DW-MRI have no statistical correlation with tumor response.