Thomas J Vogl1, Sherif A Mohamed2, Moritz H Albrecht3, Tatjana Gruber-Roh1, Han Lin4, Nour Eldin A Nour Eldin1, Iliana Bednarova5, Nagy N Naguib1, Bita Panahi1. 1. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany. 2. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany. Electronic address: sherifabdou90@gmail.com. 3. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany; Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston SC, USA. 4. Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston SC, USA. 5. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany; Institute of Diagnostic Radiology, Department of Medical and Biological Science, Udine, Italy.
Abstract
PURPOSE: To 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 METHODS: One 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. RESULTS: Four 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). CONCLUSION: The 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.
PURPOSE: To 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 METHODS: One 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. RESULTS: Four 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). CONCLUSION: The 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.
Authors: Florentine E F Timmer; Bart Geboers; Sanne Nieuwenhuizen; Evelien A C Schouten; Madelon Dijkstra; Jan J J de Vries; M Petrousjka van den Tol; Martijn R Meijerink; Hester J Scheffer Journal: Cancers (Basel) Date: 2021-03-31 Impact factor: 6.639