rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2014-0-6-33-38rentrad-56Research ArticleСтатьиХИМИОЭМБОЛИЗАЦИЯ НЕРЕЗЕКТАБЕЛЬНЫХ МЕТАСТАЗОВ КОЛОРЕКТАЛЬНОГО РАКА В ПЕЧЕНЬ МИКРОСФЕРАМИ С ЛЕКАРСТВЕННЫМ ПОКРЫТИЕМCHEMOEMBOLIZATION FOR UNRESECTABLE COLORECTAL LIVER METASTASES WITH DRUG-ELUTING MICROSPHERESСкупченкоА. В.SkupchenkoA. V.

к. м. н., заведующий отделением рентгенохирургических методов диагностики и лечения

ул. Солнечная, 50, Самара, 443031

MD, PhD, Head of Department of X-ray Surgical Methods for Diagnosis and Treatment

ul. Solnechnaya, 50, Samara, 44303

scup_chen@mail.ruЛысенкоА. В.LysenkoA. V.

ординатор

ул. Солнечная, 50, Самара, 443031

Physician 

ul. Solnechnaya, 50, Samara, 44303

КоролевД. Г.KorolevD. G.

к. м. н., ординатор

ул. Солнечная, 50, Самара, 443031

Physician 

ul. Solnechnaya, 50, Samara, 44303

СкобельцовД. А.Skobel’tsovD. A.

ординатор

ул. Солнечная, 50, Самара, 443031

Physician 

ul. Solnechnaya, 50, Samara, 44303

РассудишкинА. С.RassudishkinA. S.

ординатор

ул. Солнечная, 50, Самара, 443031

Physician 

ul. Solnechnaya, 50, Samara, 44303

ГБУЗ «Самарский областной клинический онкологический диспансер»РоссияSamara Regional Clinical Oncology DispensaryRussian Federation201402032016063338Copyright © Скупченко А.В., Лысенко А.В., Королев Д.Г., Скобельцов Д.А., Рассудишкин А.С., 20162016Скупченко А.В., Лысенко А.В., Королев Д.Г., Скобельцов Д.А., Рассудишкин А.С.Skupchenko A.V., Lysenko A.V., Korolev D.G., Skobel’tsov D.A., Rassudishkin A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/56

Цель исследования – оценка эффективности химиоэмболизации с использованием микросфер DC Bead с иринотеканом во второй линии химиотерапии метастазов колоректального рака в печень.

Материал и методы

Материал и методы. С 2008 по 2013 г. 32 пациентам с нерезектабельными метастазами колоректального рака в печень было проведено 78 химиоэмболизаций (в среднем 2,44 одному пациенту). Результаты эмболизации оценивались при помощи компьютерной томографии с использованием RECIST-критериев. Анализ выживаемости проводился с использованием метода Каплана–Майера.

Результаты

Результаты. Частичный ответ через 3, 6, 12 мес после лечения, согласно критериям RECIST, был выявлен в 4, 2 и 0% случаев соответственно. Стабилизация процесса отмечалась у 67, 53 и 12% пациентов. Полных ответов на лечение не было. Медиана времени до прогрессирования заболевания составила 225 дней, медиана выживаемости – 420 дней. К моменту проведения анализа все пациенты, включенные в исследование, умерли.

Заключение

Заключение. Химиоэмболизация микросферами с лекарственным покрытием может успешно применяться во второй линии химиотерапии метастазов колоректального рака в печень. 

Objective

Objective: to evaluate the efficiency of chemoembolization using irinotecan-loaded DC Bead microspheres in the second-line chemotherapy for colorectal liver metastases.

Material and methods

Material and methods. In 2008 to 2013, thirty-two patients with unresectable colorectal liver metastases underwent 78 chemoembolizations (mean 2.44 per patient). The results of embolization were assessed by computed tomography using the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Survival rates were analyzed applying the Kaplan–Meier method.

Results

Results. According to the RECIST criteria, a partial response at 3, 6, and 12 months of treatment was found in 4, 2, and 0%, respectively. Stabilization was noted in 67, 53, and 12%. There were no complete responses. The median time to disease progression was 225 days; median survival was 420 days. By the study analysis, all the patients included in the study died.

Conclusion

Conclusion. Chemoembolization with drug-eluting microspheres may be successfully used in the second-line chemotherapy of colorectal liver metastases.

химиоэмболизацияколоректальный ракметастазы в печеньchemoembolizationcolorectal cancerliver metastasesReferencesKameyama M., Fukuda I., Imaoka S., Sasaki Y., Shibata T., Furukawa H. et al. Transcatheter chemoembolization using Lipiodol cisplatin sandwich therapy of liver metastasis of colorectal cancer. Nihon. Gan. Chiryo. Gakkai. Shi. 1988; 23 (10): 2568–74.Kameyama M., Fukuda I., Imaoka S., Sasaki Y., Shibata T., Furukawa H. et al. Transcatheter chemoembolization using Lipiodol cisplatin sandwich therapy of liver metastasis of colorectal cancer. Nihon. Gan. Chiryo. Gakkai. Shi. 1988; 23 (10): 2568–74.Itani K., Yoshikawa T., Oyamada H., Takano H., Ichikawa H., Tainaka K. et al. Chemoembolization with degradable starch microspheres for liver metastases in colorectal cancer. Gan To Kagaku Ryoho. 1989; 16 (8; Pt 2): 2897–900.Itani K., Yoshikawa T., Oyamada H., Takano H., Ichikawa H., Tainaka K. et al. Chemoembolization with degradable starch microspheres for liver metastases in colorectal cancer. Gan To Kagaku Ryoho. 1989; 16 (8; Pt 2): 2897–900.Lorenz M., Herrmann G., Kirkowa-Reimann M., Rauber K., Herrhausen T., Henne T., Hottenrott C. Temporary chemoembolization of colorectal liver metastases with degradable starch microspheres. Eur. J. Surg. Oncol. 1989; 15 (5): 453–62.Lorenz M., Herrmann G., Kirkowa-Reimann M., Rauber K., Herrhausen T., Henne T., Hottenrott C. Temporary chemoembolization of colorectal liver metastases with degradable starch microspheres. Eur. J. Surg. Oncol. 1989; 15 (5): 453–62.Lang E.K., Brown C.L. Jr. Colorectal metastases to the liver: selective chemoembolization. Radiology. 1993; 189 (2): 417–22.Lang E.K., Brown C.L. Jr. Colorectal metastases to the liver: selective chemoembolization. Radiology. 1993; 189 (2): 417–22.Таразов П.Г. Артериальная химиоэмболизация при метастазах колоректального рака в печень. Вопросы онкологии. 2000; 46 (5): 561–6. Tarazov P.G. Arterial chemoembolization for metastatic colorectal cancer in the liver. Voprosy onkologii. 2000; 46 (5): 561–6 (in Russian).Таразов П.Г. Артериальная химиоэмболизация при метастазах колоректального рака в печень. Вопросы онкологии. 2000; 46 (5): 561–6. Tarazov P.G. Arterial chemoembolization for metastatic colorectal cancer in the liver. Voprosy onkologii. 2000; 46 (5): 561–6 (in Russian).Vogl T.J., Gruber T., Balzer J.O., Eichler K., Hammerstingl R., Zangos S. Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study. Radiology. 2009; 250 (1): 281–9. doi: 10.1148/radiol.2501080295Vogl T.J., Gruber T., Balzer J.O., Eichler K., Hammerstingl R., Zangos S. Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study. Radiology. 2009; 250 (1): 281–9. doi: 10.1148/radiol.2501080295Albert M., Kiefer M.V., Sun W., Haller D., Fraker D.L., Tuite C.M. et al. Chemoembolization of colorectal liver metastases with cisplatin, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol. Cancer. 2011; 117 (2): 343–52. doi: 10.1002/cncr.25387Albert M., Kiefer M.V., Sun W., Haller D., Fraker D.L., Tuite C.M. et al. Chemoembolization of colorectal liver metastases with cisplatin, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol. Cancer. 2011; 117 (2): 343–52. doi: 10.1002/cncr.25387Fiorentini G., Aliberti C., Tilli M., Mulazzani L., Graziano F., Giordani P. et al. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res. 2012; 32 (4): 1387–95.Fiorentini G., Aliberti C., Tilli M., Mulazzani L., Graziano F., Giordani P. et al. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res. 2012; 32 (4): 1387–95.Poggi G., Quaretti P., Minoia C., Bernardo G., Bonora M.R., Gaggeri R. et al. Transhepatic arterial chemoembolization with oxaliplatineluting microspheres (OEM-TACE) for unresectable hepatic tumors. Anticancer Res. 2008; 28 (6B): 3835–42.Poggi G., Quaretti P., Minoia C., Bernardo G., Bonora M.R., Gaggeri R. et al. Transhepatic arterial chemoembolization with oxaliplatineluting microspheres (OEM-TACE) for unresectable hepatic tumors. Anticancer Res. 2008; 28 (6B): 3835–42.Huppert P., Wenzel T., Wietholtz H. Transcatheter Arterial Chemoembolization (TACE) of colorectal cancer liver metastases by irinotecan-eluting microspheres in a salvage patient population. Cardiovasc. Intervent. Radiol. 2014; 37 (1): 154–64.Huppert P., Wenzel T., Wietholtz H. Transcatheter Arterial Chemoembolization (TACE) of colorectal cancer liver metastases by irinotecan-eluting microspheres in a salvage patient population. Cardiovasc. Intervent. Radiol. 2014; 37 (1): 154–64.Müller H., Nakchbandi V., Chatzisavvidis I., von Voigt C. Repetitive chemoembolization with melphalan plus intra-arterial immunochemotherapy within 5-fluorouracil and granulocyte-macrophagecolony-stimulating factor (GM-CSF) as effective first- and second-line treatment of disseminated colorectal liver metastases. Hepatogastroenterology. 2003; 50 (54): 1919–26.Müller H., Nakchbandi V., Chatzisavvidis I., von Voigt C. Repetitive chemoembolization with melphalan plus intra-arterial immunochemotherapy within 5-fluorouracil and granulocyte-macrophagecolony-stimulating factor (GM-CSF) as effective first- and second-line treatment of disseminated colorectal liver metastases. Hepatogastroenterology. 2003; 50 (54): 1919–26.Martin R.C. 2nd, Scoggins C.R., Tomalty D., Schreeder M., Metzger T., Tatum C., Sharma V. Irinotecan drug-eluting beads in the treatment of chemo-naive unresectable colorectal liver metastasis with concomitant systemic fluorouracil and oxaliplatin: results of pharmacokinetics and phase I trial. J. Gastrointest. Surg. 2012; 16 (8): 1531–8. doi: 10.1007/s11605-012-1892-8.Martin R.C. 2nd, Scoggins C.R., Tomalty D., Schreeder M., Metzger T., Tatum C., Sharma V. Irinotecan drug-eluting beads in the treatment of chemo-naive unresectable colorectal liver metastasis with concomitant systemic fluorouracil and oxaliplatin: results of pharmacokinetics and phase I trial. J. Gastrointest. Surg. 2012; 16 (8): 1531–8. doi: 10.1007/s11605-012-1892-8.

The authors declare that there are no conflicts of interest present.