04:12 PM Abstract No. 120 Lung shunt fraction and radiation segmentectomy

Abstract

disease, unilateral hepatic artery embolization can be utilized to safely deliver treatment to both lobes via intrahepatic collateral formation. This study compares the effectiveness of therapy delivery to tumors supplied by the native hepatic artery to those supplied by intrahepatic collaterals following unilateral artery RE. Materials: A single-institution retrospective review was performed of all patients who underwent RE from 2009 through 2018. The study population included patients that underwent hepatic arterial embolization with the intent of treating via intrahepatic collaterals. Cross sectional imaging, both prior to and following RE, was reviewed to assess treatment response. Modified RECIST criteria was used to classify disease in each hepatic lobe as stable, improved, or worsened. Tumor response for lobes supplied by the native hepatic artery and for lobes supplied by intrahepatic collaterals were compared to assess for differences in treatment efficacy. Results: Of the 313 patients reviewed,15 patients underwent hepatic arterial embolization with the intent of redistribution, and 9 met inclusion criteria. Most patients were treated for metastatic colon cancer or hepatocellular carcinoma. In all but one patient, tumor response in both territories fell into the same mRECIST criteria category. In the one patient that showed a variant response, the territory treated via collaterals actually improved and the native territory progressed. Tumor response was not significantly different between the two tumor groups (p>0.05). Conclusions: Unilateral artery embolization can be used in the setting of variant arterial anatomy to deliver RE therapy to both hepatic lobes via intrahepatic collaterals. This decreases the risk of extrahepatic microsphere delivery without sacrificing tumor treatment response.