scholarly journals Διεπεμβατικός και μετεπεμβατικός έλεγχος με CEUS στον χημειοεμβολισμό με σφαιρίδια που εκλύουν χημειοθεραπευτικά

2015 ◽  
Author(s):  
Ιπποκράτης Μοσχούρης
Keyword(s):  
Overall Survival ◽  
Transarterial Chemoembolization ◽  
Progression Free Survival ◽  
Free Survival ◽  
Contrast Enhanced ◽  
Drug Eluting Beads ◽  
Drug Eluting ◽  
Contrast Enhanced Ultrasonography

Σκοπός: Να αξιολογηθεί η υπερηχογραφία με ενισχυτές ηχογένειας (contrast-enhanced ultrasonography, CEUS) σαν μέθοδος διεπεμβατικής και μετεπεμβατικής αξιολόγησης του χημειοεμβολισμού με σφαιρίδια εκλύοντα χημειοθεραπευτικό (transarterial chemoembolization with drug-eluting beads, DEB-TACE). Να αξιολογηθεί ο συνδυασμός CEUS με ευρέως αποδεκτά κριτήρια ανταπόκρισης και πρόγνωσης.Υλικό-Μέθοδος: Μελετήθηκαν 63 ασθενείς, με 109 όγκους-στόχους (52 ασθενείς με ηπατοκυτταρικό καρκίνωμα, 9 ασθενείς με ηπατικές μεταστάσεις, 2 ασθενεις με ενδοηπατικό χολαγγειοκαρκίνωμα), οι οποίοι υπεβλήθησαν σε DEB-TACE ανά 5-7 εβδομάδες. Ο απεικονιστικός έλεγχος συμπεριέλαβε μία δυναμική εξέταση αναφοράς (υπολογιστική ή μαγνητική τομογραφία) και CEUS. Επί των απεικονιστικών ευρημάτων εφαρμόστηκαν τα κριτήρια ανταπόκρισης RECIST, mRECIST and EASL. Η απεικονιστική ανταπόκριση συσχετίστηκε με την συνολική επιβίωση (overall survival, OS) και την επιβίωση ελεύθερη προόδου νόσου (progression-free survival, PFS). Αποτελέσματα: Παρατηρήθηκε υψηλού βαθμού συμφωνία μεταξύ της CEUS και της εξέτασης αναφοράς στην αξιολόγηση της ανταπόκρισης κατά mRECIST (k=0.84, p<0.001). Ασθενείς με ανταπόκριση (κατά mRECIST-CEUS), είχαν σημαντικά μεγαλύτερη OS και PFS σε σύγκριση με τους υπόλοιπους (37.1 vs 11.0 μήνες, p<0.001 και 24.6 vs 10.9 μήνες, p=0.007,αντίστοιχα). Τα κριτήρια mRECIST είχαν υψηλότερη προγνωστική αξία από τα RECIST. Συμπέρασμα: Στο πλαίσιο της αξιολόγησης ηπατικών όγκων μετά DEB-TACE, ο συνδυασμός της CEUS με ευρέως αποδεκτά κριτήρια ανταπόκρισης φαίνεται εφικτός και με προγνωστική αξία.

scholarly journals Drug-eluting Bead transarterial chemoembolization in patients with renal carcinoma

2020 ◽  
Author(s):  
Zhiyu Bao ◽  
Haiyan Wu ◽  
Zhonghua Qiu ◽  
Meng Hu ◽  
Yanyan Yang ◽  
...  
Keyword(s):  
Transarterial Chemoembolization ◽  
Renal Carcinoma ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Progression Free Survival ◽  
Serious Adverse Events ◽  
Free Survival ◽  
Kaplan Meier ◽  
Drug Eluting Beads ◽  
Drug Eluting

Abstract Background This study aimed to investigate the efficacy,safety and outcomes of patients with renal carcinoma treated by transarterial chemoembolization using drug eluting beads. Methods Between 2017 and 2020,37 patients(mean age:70.2 years(33–92 years)) with renal carcinoma were enrolled in this study who were treated by transarterial chemoembolization(TACE)using pirarubicin-loaded beads.Clinical response was evaluated according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria.The occurrence of adverse reactions was used to assess safety.Overall survival(OS), progression-free survival(PFS) were also calculated based on Kaplan–Meier method. Results All patients were treated with drug-eluting Bead transarterial chemoembolization(DEB-TACE) loaded with pirarubicin using CalliSpheres beads.The objective response rate(ORR) and disease control rate(DCR) were 75.7% and 91.9% respectively at 1 month after DEB-TACE.The median PFS was 13.2 months (95% CI:5.9–20.5 months), and the median OS was 23.6 months (95% CI:18.5–28.7 months).Among the 37 patients,12 had flank pain,5 had fever,5 had nausea and vomiting and 4 had hypertension.There were no serious adverse events. Conclusion DEB-TACE is a safe and feasible treatment for patients with renal carcinoma.

Randomized controlled trial of irinotecan drug-eluting beads with simultaneous FOLFOX and bevacizamab for patients with unresectable colorectal liver-limited metastasis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 174-174 ◽  
Author(s):  
Robert C. G. Martin ◽  
Charles R. Scoggins ◽  
William S. Rilling ◽  
Marshall T. Schreeder ◽  
John S. Kauh ◽  
...  
Keyword(s):  
Adverse Event ◽  
Controlled Trial ◽  
Progression Free Survival ◽  
Response Rates ◽  
Adverse Event Rate ◽  
Maximal Response ◽  
Free Survival ◽  
Overall Response ◽  
Drug Eluting Beads ◽  
Drug Eluting

174 Background: Reports have demonstrated the activity of combining both Irinotecan and Oxaliplatin into a FOLFOXIRI therapy. An option to gain similar benefits and less toxicity to FOLFOXIRI would be to administer the irinotecan through an hepatic arterial apporach. The aim of this study was to assess the maximal response and adverse event rates of Irinotecan Drug Eluting Beads (DEBIRI) with FOLFOX and Bevacizumab (Bev) as a first line treatment for unresectable colorectal liver metastasis (CLMs). Methods: Metachronous and Synchronous CLMs were randomly assigned to mFOLFOX6/Bev or mFOLFOX6, Bev and DEBIRI (FOLFOXDEBIRI). Primary end point was optimal response rates and adverse events. Secondary endpoints were patients (pts) converted to resection and survival. Results: The intention-to-treat population comprised 70 pts, 40 pts randomly assigned to the FOLFOXDEBIRI arm and 30 pts to FOLFOX/Bev arm. Both were similar with synchronous disease (50% vs. 36%), extent liver involvement (35% vs. 31%), but greater percentage in the FOLFOXDEBIRI arm of ECOG 1/2 (57% vs. 31%), p=0.04) and extra-hepatic disease (51% vs. 36%, p=0.02). Median number of chemotherapy cycles was similar in both arms of 8, with a similar Grade 3/4 adverse event rate of 54% FOLFOXDEBIRI and 46% FOLFOX/Bev arm. The overall response rate was significantly greater in the FOLFOXDEBIRI arm vs. FOLFOX/BEV at 2 mons (78% vs. 54%), 4 mons (95% vs. 70%) and 6 mons (76% vs. 60%, p=0.03). Significantly greater downsizing to resection in the FOLFOXDEBIRI arm vs. FOLFOX/Bev (35% vs. 16%, p=0.05), with an improved median progression free survival (15.3 mons vs. 7.6 mons). Overall improvement in hepatic specific progression free survival was seen in the treatment arm (12.8 mons vs. 10.5 mons). Conclusions: Simultaneous mFOLFOX6 with bevacizumab and hepatic arterial irinotecan drug eluting beads is safe, without causing chemotherapy delivery delays and without increasing chemotherapy toxicity. Simultaneous FOLFOXDEBIRI leads to improved overall response rates, improved hepatic progression free survival, and more durable overall progression free survival in patients downsized to resection. Clinical trial information: NCT00932438.

scholarly journals Predicting Therapeutic Efficacy of Transarterial Chemoembolization with Drug-Eluting Beads for Hepatocellular Carcinoma Using Contrast-Enhanced Ultrasound

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 291
Author(s):  
Kazue Shiozawa ◽  
Takashi Matsui ◽  
Takahiro Murakami ◽  
Manabu Watanabe ◽  
Iruru Maetani
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Therapeutic Efficacy ◽  
Response Rates ◽  
Contrast Enhanced Ultrasound ◽  
Enhancement Pattern ◽  
Contrast Enhanced ◽  
Peripheral Ring ◽  
Drug Eluting Beads ◽  
Drug Eluting

The aim of this study was to assess the usefulness of contrast-enhanced ultrasound (CEUS) for predicting the therapeutic efficacy of transarterial chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma (HCC). Thirty-two patients with HCC who underwent DEB-TACE were enrolled in this study. Enhancement patterns of vascular phase images on CEUS were compared before and within 3 days after DEB-TACE, and the patterns after DEB-TACE were classified as follows: Pattern A, no enhancement; Pattern B, peripheral ring enhancement; Pattern C, partial enhancement within or peripheral to tumors, and Pattern D, reduced or unchanged enhancement in the whole tumor. Enhancement patterns in all lesions and contrast-enhanced computed tomography (CECT) findings after DEB-TACE were compared statistically. The treatment response of DEB-TACE was evaluated using the Modified Response Evaluation Criteria in Solid Tumors (mRECIST) by CECT. The enhancement patterns on CEUS performed within 3 days after DEB-TACE were defined as Pattern A in 17 cases, B in 7, C in 13, and D in 2. The complete response rates at one month after treatment were 94.1% (16/17 lesions) for Pattern A, 85.7% (6/7) for B, 15.4% (2/13) for C, and 50% (1/2) for D. The response rates were significantly higher for lesions with Pattern A compared to those with Pattern C at one month (p = 0.009) and 12 months (p < 0.001) after treatment, and significantly higher for lesions with Pattern B compared to those with Pattern C at 12 months after treatment (p = 0.031). Comparisons between other patterns showed no significant differences. CEUS immediately after DEB-TACE may allow early assessment of therapeutic efficacy, with findings of no enhancement or peripheral ring enhancement suggesting a positive outcome.

scholarly journals Transarterial Chemoembolization of Hepatocellular Carcinoma with Oncozene Microspheres: An Initial, Short-Term Clinical Experience—A Retrospective, Matched, Comparison Study

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 600
Author(s):  
Matthew L. Hung ◽  
Jerry Jiang ◽  
Harry Trieu ◽  
Frank Hao ◽  
Navid Eghbalieh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Transarterial Chemoembolization ◽  
Tumor Response ◽  
Progression Free Survival ◽  
Embolic Agent ◽  
Rank Test ◽  
Fisher Exact Test ◽  
Short Term ◽  
Free Survival

Background: The purpose of this study is to describe a single institution’s experience using Oncozene (OZ) microspheres for transarterial chemoembolization (OZ-TACE) of hepatocellular carcinoma (HCC), and to compare tolerability, safety, short-term radiographic tumor response, progression-free survival (PFS), and overall survival (OS) of these procedures to TACE (LC-TACE) performed with LC beads (LC). Methods: A retrospective, matched cohort study of patients undergoing DEB-TACE (drug-eluting bead transarterial chemoembolization) with OZ or LC was performed. The cohort comprised 23 patients undergoing 29 TACE with 75 or 100 μm OZ and 24 patients undergoing 29 TACE with 100–300 μm LC. Outcome measures were changes in liver function tests, complications, treatment tolerability, short-term radiographic tumor response according to modified RECIST criteria for HCC, PFS, and 1-year OS. The Mann–Whitney U test, Fisher exact test, and log rank test were used to compare the groups. Results: The BCLC or Child–Pugh scores were similar between the OZ and LC group. However, the two groups differed with respect to the etiology of background cirrhosis (p = 0.02). All other initial demographic and tumor characteristics were similar between the two groups. OZ-TACE used less doxorubicin per treatment compared to LC-TACE (median 50 vs. 75 mg; p = 0.0005). Rates of pain, nausea, and postembolization syndrome were similar, irrespective of the embolic agent used. OZ-TACE resulted in an overall complication rate comparable to LC-TACE (20.7% vs. 10.3%; p = 0.47). LC-TACE resulted in a higher percent increase in total bilirubin on post-procedure day 1 (median 18.8 vs. 0%; p = 0.05), but this difference resolved at 1 month. Both OZ-TACE and LC-TACE resulted in similar complete (31% vs. 24%) and objective (66% vs. 79%) target lesion response rates on 1-month post-TACE imaging. Both OZ-TACE and LC-TACE had similar median progression-free survival (283 vs. 209 days; p = 0.14) and 1-year overall survival rates (85% vs. 76%; p = 0.30). Conclusion: With a significantly reduced dose of doxorubicin, TACE performed with Oncozene microspheres in a heterogeneous patient population is well-tolerated, safe, and produces a similar radiological response and survival rate when compared to LC Bead TACE.

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