scholarly journals Complications Following Irinotecan-Loaded Microsphere Chemoembolization of Colorectal Metastatic Liver Lesions Associated with Hepatic-Artery Branch Temporary Stasis

2021 ◽  
Vol 28 (3) ◽  
pp. 2296-2307
Author(s):  
Marcin Szemitko ◽  
Elzbieta Golubinska-Szemitko ◽  
Jerzy Sienko ◽  
Aleksander Falkowski
Keyword(s):  
Colorectal Cancer ◽  
Adverse Events ◽  
Liver Metastases ◽  
Hepatic Artery ◽  
Liver Lesions ◽  
Apparent Lack ◽  
Neoplastic Lesion ◽  
Hepatic Artery Branch ◽  
Artery Branch ◽  
Metastatic Liver

Chemoembolization with irinotecan-loaded microspheres has proven effective in the treatment of unresectable liver metastases in the course of colorectal cancer (CRC). Most researchers recommend slowly administering the embolizate at the level of the lobar arteries, without obtaining visible stasis. However, there are reports of a relationship between postoperative embolizate retention in metastatic lesions and the response to treatment. To retain residual embolizate throughout the entire neoplastic lesion requires a temporary flow stop (stasis) within all supply vessels, which may cause temporary stasis in subsegmental or even segmental vessels. Objective: To assess the risk of complications and post-embolization syndrome severity following chemoembolization of CRC metastatic liver lesions with microspheres loaded with Irinotecan, with regard to hepatic-artery branch level of temporary stasis. Patients and methods: The study included 52 patients (29 female, 23 male) with liver metastases from CRC, who underwent 202 chemoembolization treatments (mean: 3.88 per patient) with microspheres loaded with 100 mg irinotecan. Postembolization syndrome (PES) severity and complication occurrence were assessed with regard to the hepatic-artery branch level of temporary stasis. Adverse events were assessed according to Cancer Therapy Evaluation Program Common Terminology Criteria for Adverse Events. Results: Median survival from the start of chemoembolization was 13 months. From 202 chemoembolization sessions, 15 (7.4%) significant complications were found. The study found a significant relationship between the branch level of temporary stasis and the presence of complications (p < 0.001), with the highest number of complications observed with temporary stasis in segmental vessels. PES was diagnosed after 103 (51%) chemoembolization treatments. A significant association was found between PES severity and the branch level of temporary stasis (p < 0.001). Conclusions: The branch level of temporary stasis affected the severity of post-embolization syndrome. A significant association was found between the branch level of temporary stasis obtained in chemoembolization procedures and the presence of complications. The apparent lack of change in numbers of complications when stasis was applied at tumor supply vessels or subsegmental arteries may indicate the safe use of temporary stasis in some cases where colorectal cancer metastases are treated. Further research is needed to determine the most effective chemoembolization technique.

scholarly journals Side Effect/Complication Risk Related to Injection Branch Level of Chemoembolization in Treatment of Metastatic Liver Lesions from Colorectal Cancer

2020 ◽  
Vol 10 (1) ◽  
pp. 121
Author(s):  
Marcin Szemitko ◽  
Elzbieta Golubinska-Szemitko ◽  
Ewa Wilk-Milczarek ◽  
Aleksander Falkowski
Keyword(s):  
Colorectal Cancer ◽  
Adverse Events ◽  
Liver Metastases ◽  
Objective Assessment ◽  
Liver Parenchyma ◽  
Liver Lesion ◽  
Metastatic Lesion ◽  
Complication Risk ◽  
Postembolization Syndrome ◽  
Metastatic Liver

Purpose: Transarterial chemoembolization with drug eluting beads (DEB-TACE) loaded with irinotecan despite having proven efficacy in the treatment of unresectable liver metastases in the course of colorectal cancer (CRC) does not have an established consistent method. In particular, there are discrepancies in the branch level at which microspheres are administered. Lobar embolization supplies microspheres to all vessels supplying a metastatic lesion but exposes the entire liver parenchyma to negative effects from microsphere irinotecan. Superselective chemoembolization compromises healthy liver parenchyma less but may omit small vessels supplying metastatic lesions. Objective: Assessment of the risk of complications and the severity of postembolization syndromes with CRC metastatic liver lesion chemoembolization with irinotecan-loaded microspheres, according to branch level of chemoembolization. Patients and methods: The analysis included 49 patients (27 female/22 male) with liver metastases in the course of CRC, who underwent 192 chemoembolization treatments (mean 3.62 per patient) with microspheres loaded with 100 mg irinotecan. The procedures were performed according to an adopted schema: alternating the right and left lobe of the liver at 3-week intervals. The severity of postembolization syndrome (PES) and the presence of complications were assessed according to the branch level of chemoembolization; microspheres were administered at the branch level of lobar, segmental, or subsegmental arteries. Assessment of adverse events was performed according to the standards of the Cancer Therapy Evaluation Program Common Terminology Criteria for Adverse Events, Version 5.0. Results: The median survival of all patients from the start of chemoembolization was 13 months. With 192 chemoembolization sessions, 14 (7.3%) serious complications were found. The study showed no significant relationship between the branch level of embolizate administration and the presence of complications (p = 0.2307). Postembolization syndrome was diagnosed after 102 chemoembolization treatments, i.e., 53.1% of treatments. A significant correlation was found between the severity of the postembolization syndrome and the branch level of embolization treatment (p = 0.00303). The mean PES severity increased from subsegmental through segmental to lobar administration. Conclusion: Chemoembolization using Irinotecan-loaded microspheres was relatively well tolerated by patients and gave a low risk of significant complications, which did not change with the branch level of microsphere administration. However, an association was found between the branch level of chemoembolization and the severity of postembolization syndrome. Further research is needed to determine the most effective DEB-TACE chemoembolization technique.

False aneurysm of a hepatic artery branch and a recurrent subphrenic abscess

1996 ◽  
Vol 10 (2) ◽  
pp. 161-163 ◽  
Author(s):  
R. J. Porte ◽  
E. G. Coerkamp ◽  
R. K. J. Koumans
Keyword(s):  
Hepatic Artery ◽  
False Aneurysm ◽  
Subphrenic Abscess ◽  
Hepatic Artery Branch ◽  
Artery Branch

scholarly journals Modern Prospection for Hepatic Arterial Infusion Chemotherapy in Malignancies with Liver Metastases

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Yi-Hsin Liang ◽  
Yu-Yun Shao ◽  
Jia-Yi Chen ◽  
Po-Chin Liang ◽  
Ann-Lii Cheng ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Hepatic Artery ◽  
Liver Tumors ◽  
Hepatic Artery Infusion ◽  
Special Focus ◽  
Infusion Chemotherapy ◽  
Study Results ◽  
Hepatic Artery Infusion Chemotherapy ◽  
Metastatic Liver Tumors ◽  
Metastatic Liver

Malignancy with liver metastasis plays an important role in daily oncology practice, especially for primary cancers of the gastrointestinal tract and hepatopancreatobiliary system. On account of the dual vascular supply system and the fact that most metastatic liver tumors are supplied by the hepatic artery, hepatic artery infusion chemotherapy (HAIC) is an appealing method for the treatment of liver metastases. Herein, we summarize recent study results reported in the literature regarding the use of HAIC for metastatic liver tumors, with special focus on colorectal cancer.

scholarly journals Transarterial Chemoembolization of Metastatic Liver Lesions in Patients with Colorectal Cancer

2019 ◽  
Vol 29 (5) ◽  
pp. 36-42
Author(s):  
O. Yu. Stukalova ◽  
G. P. Gens ◽  
Z. Kh. Shugushev ◽  
V. V. Maslov ◽  
A. G. Chepurnoy
Keyword(s):  
Colorectal Cancer ◽  
Partial Response ◽  
Transarterial Chemoembolization ◽  
Long Term Results ◽  
Liver Lesions ◽  
Treatment Services ◽  
Recist 1.1 ◽  
Oncology Centre ◽  
Metastatic Liver

Aim. To evaluate the efficacy of transarterial chemoembolization in patients with metastases of colorectal cancer in the liver.Materials and methods. A study aimed at investigating the effect of selective transarterial chemoembolization (TACE) of the hepatic artery on liver metastases in colorectal cancer was conducted at the Oncology Centre of the RZhD Central Clinical Hospital No. 2 named after N.A. Semashko, Moscow. The research basis included data for 10 patients, who had undergone chemoembolization of the hepatic arteries using Biosphere microspheres 50– 100 µm — 25 mg and doxorubicin 50 mg.Results. Both immediate and long-term results of up to 12 months were evaluated using the RECIST 1.1 scale. A partial response was achieved after 4 TACE treatments in 22.2 % of cases. The stabilization of the oncological process in the liver was observed after 9 TACE treatments in 50 % of cases. Disease progression was noted after 5 procedures in 27.8 % of cases.Conclusions. Transarterial chemoembolization of metastatic liver lesions in patients with colorectal cancer can be used according to certain indications in specialized centres providing endovascular treatment services.

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