Polyethylene Glycol Embolics Loaded With Irinotecan for Chemoembolization of Metastatic Liver Cancer
AUTHORS: C. Aliberti2, R. Carandina2, D. Sarti1, L. Mulazzani3, E. Pizzirani2, G. Ramondo2, G. Fiorentini1
INSTITUTIONS: 1. Oncology, , Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy. 2. OncologyRadiodiagnostics, Istituto Oncologico Veneto, Padova, Italy. 3. Azienda Ospedaliera “Ospedali Riuniti Marche Nord”, Diagnostics for Images Unit and InterventionalRadiology, Pesaro, Italy.
Patients with liver metastases from colorectal cancer are in 80% of cases non indicated for resection. The standard first line treatment of unresectablelivermetastases is systemic chemotherapy, however this method results in progression for 70% of patients. The indicated therapy for refractory patients is the chemoembolization. In this study we monitored tumor response, and adverse events after chemoembolization of colorectal cancer liver metastases with polyethylene glycol embolics loaded with irinotecan. Secondary objectives were to monitor quality of life, time to progression and survival of patients.
Patients were included in the study if: affected by CRC-LM, who were refractory to systemic chemotherapy,
treated with chemoembolization using polythylene glycol embolics, and liver involvement >50%. Tumor response,
performance status (PS), tumor marker antigens, and quality of life (QoL) were monitored at 1, 3 and 6 months after chemoembolization. QoL was assessed with the palliative scale (PSS).
We treated 50 consecutive CRC-LM patients with chemoembolization using polythylene glycol embolics, their tumor response one month after chemoembolization was 28% of complete response (CR), and 48% of partial response (PR), 8% stable disease (SD), and 16% of progression. Tumor response 3 months (mo) after chemoembolization was CR 24%, PR 38%, SD 19% and progression disease (PD) 19%. Tumor response 6 months after chemoembolization was CR 18%, PR 44%, SD 21% and progression disease (PD) 18%. QoL was 90% PPS at each time point. Median time to progression was 2,5 months (range 0,8 - 6). Median follow-up was 14 months (0,8-25 range).
Chemoembolizations were performed with no complications. Observed side effects (mild or moderate intensity) were: pain in 32% of patients, increase of transaminase levels in 20% fever in 14%, whereas 30% of patients did not complain any adverse event.
Chemoembolization of CRC-LM with polyethylene glycol embolics loaded with irinotecan was effective in
tumor response and resulted in mild toxicity, and good QoL.