Jean-Pierre Pelage1,2, Audrey Fohlen3,4, Emmanuel Mitry5, Christine Lagrange6, Alain Beauchet7, Philippe Rougier5. 1. Department of Diagnostic Imaging and Interventional Radiology, Caen University and Medical Center, Avenue Cote de Nacre, 14033, Caen Cedex 9, France. pelage-jp@chu-caen.fr. 2. CERVOxy, CEA, CNRS, ISTCT - Imagerie et Stratégie Thérapeutiques des Pathologies Cérébrales et Tumorales (M Bernaudin), Université de Basse-Normandie UNICAEN, Caen, France. pelage-jp@chu-caen.fr. 3. Department of Diagnostic Imaging and Interventional Radiology, Caen University and Medical Center, Avenue Cote de Nacre, 14033, Caen Cedex 9, France. 4. CERVOxy, CEA, CNRS, ISTCT - Imagerie et Stratégie Thérapeutiques des Pathologies Cérébrales et Tumorales (M Bernaudin), Université de Basse-Normandie UNICAEN, Caen, France. 5. Department of Hepatogastroenterology and Oncology, Hopital Ambroise Pare, 9, Avenue Charles de Gaulle, 92104, Boulogne Cedex, France. 6. Department of Radiology, Hopital Ambroise Pare, 9, Avenue Charles de Gaulle, 92104, Boulogne Cedex, France. 7. Department of Biostatistics and Public Health, Hopital Ambroise Pare, 9, Avenue Charles de Gaulle, 92104, Boulogne Cedex, France.
Abstract
PURPOSE: The purpose of this prospective observational study was to evaluate the efficacy and tolerability of transarterial chemoembolization (TACE) for neuroendocrine liver metastases using a combination of streptozocin, Lipiodol, and tris-acryl microspheres. PATIENTS AND METHODS: A total of 16 men and 9 women aged 59.6 ± 11.3 years, all with predominant liver disease, underwent 54 courses of TACE using an emulsion of 1.5 g of streptozocin and 10 ml of Lipiodol. Additional embolization was performed using 300-500 µm tris-acryl microspheres. Morphological response was evaluated using the RECIST criteria on multi-detector computed tomography or MRI. Clinical efficacy was evaluated particularly in patients with carcinoid syndrome. RESULTS: The primary tumor was located in the small bowel or pancreas in 21 (84%) patients. Eleven (44%) patients presented with a carcinoid syndrome. Nineteen (76%) patients presented with more than 10 liver nodules. One delayed case of ischemic cholecystitis was treated conservatively. After a median follow-up of 36.1 months, 1 (4%) patient had a complete response, 12 (48%) patients had a partial response, and 7 (28%) patients had a stable disease corresponding to a disease control rate of 80%. All patients with carcinoid syndrome had significant improvement. Median time to progression was 18.8 months and overall survival was 100, 100, and 92% at 1, 2, and 3 years, respectively. Seven patients presented with extrahepatic progression with abdominal lymphadenopathies or metastases to the brain, ovary, adrenal gland, or lung. CONCLUSION: Optimized TACE using a combination of streptozocin, Lipiodol, and tris-acryl microspheres is effective and well tolerated.
PURPOSE: The purpose of this prospective observational study was to evaluate the efficacy and tolerability of transarterial chemoembolization (TACE) for neuroendocrine liver metastases using a combination of streptozocin, Lipiodol, and tris-acryl microspheres. PATIENTS AND METHODS: A total of 16 men and 9 women aged 59.6 ± 11.3 years, all with predominant liver disease, underwent 54 courses of TACE using an emulsion of 1.5 g of streptozocin and 10 ml of Lipiodol. Additional embolization was performed using 300-500 µm tris-acryl microspheres. Morphological response was evaluated using the RECIST criteria on multi-detector computed tomography or MRI. Clinical efficacy was evaluated particularly in patients with carcinoid syndrome. RESULTS: The primary tumor was located in the small bowel or pancreas in 21 (84%) patients. Eleven (44%) patients presented with a carcinoid syndrome. Nineteen (76%) patients presented with more than 10 liver nodules. One delayed case of ischemic cholecystitis was treated conservatively. After a median follow-up of 36.1 months, 1 (4%) patient had a complete response, 12 (48%) patients had a partial response, and 7 (28%) patients had a stable disease corresponding to a disease control rate of 80%. All patients with carcinoid syndrome had significant improvement. Median time to progression was 18.8 months and overall survival was 100, 100, and 92% at 1, 2, and 3 years, respectively. Seven patients presented with extrahepatic progression with abdominal lymphadenopathies or metastases to the brain, ovary, adrenal gland, or lung. CONCLUSION: Optimized TACE using a combination of streptozocin, Lipiodol, and tris-acryl microspheres is effective and well tolerated.
Authors: Yiming Liu; Haikuan Liu; Wenchuan Chen; Hang Yu; Wang Yao; Wenzhe Fan; Jiaping Li; Minhu Chen; Jie Chen; Yu Wang Journal: Cancer Med Date: 2022-03-14 Impact factor: 4.711
Authors: Giuseppe Nigri; Niccolò Petrucciani; Tarek Debs; Livia Maria Mangogna; Anna Crovetto; Giovanni Moschetta; Raffaello Persechino; Paolo Aurello; Giovanni Ramacciato Journal: World J Surg Oncol Date: 2018-07-14 Impact factor: 2.754