Neoadjuvant TACE before laser induced thermotherapy (LITT) in the treatment of non-colorectal non-breast cancer liver metastases: Feasibility and survival rates

Vogl, Thomas J.; Kreutzträger, Martin; Gruber‐Rouh, Tatjana; Eichler, Katrin; Nour-Eldin, Nour-Eldin A.; Zangos, Stephan; Naguib, N

doi:10.1016/j.ejrad.2014.06.029

Cited by 11 publications

(5 citation statements)

References 24 publications

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“…5,6 In addition, TACE alone or in combination with laser induced thermotherapy resulted in improved patient survival in patients with unresectable noncolorectal and nonbreast cancer origin. 7 …”

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confidence: 99%

Functional Magnetic Resonance Imaging Response of Targeted Tumor Burden and Its Impact on Survival in Patients With Hepatocellular Carcinoma

Corona‐Villalobos

Halappa

Bonekamp

et al. 2015

Investigative Radiology

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Purpose The aim of this study was to evaluate response of the targeted tumor burden by functional magnetic resonance imaging (MRI) including volumetric diffusion-weighted imaging and volumetric contrast-enhanced MRI (CE-MRI) and its impact on survival in patients with hepatocellular carcinoma treated with intra-arterial therapy (IAT). Materials and Methods This institutional review board–approved, Health Insurance Portability and Accountability Act–compliant retrospective study included 157 hepatocellular carcinoma lesions in 97 patients (78 men and 19 women; mean age, 64 years) treated with IAT. All patients had pretreatment and 3- to 4-week follow-up MRI with diffusion-weighted imaging and CE-MRI. All lesions 2 cm or larger that were targeted during the first session of IAT were segmented using research software (MR-Oncotreat) to determine targeted tumor burden relative to liver volume (%). Targeted tumor burden was stratified into low (≤10%) or high (>10%). Response using volumetric functional apparent diffusion coefficient (ADC; increase by ≥25%) and CE-MRI (decrease by ≥50% and ≥65% in arterial and venous enhancement [VE], respectively) was assessed in all targeted tumors (range, 1–11) using paired t tests. Kaplan-Meier survival analysis was performed and log-rank test was used to compare pairs of survival curves. Multivariate Cox regression analysis was performed to determine the simultaneous effect of treatment response and tumor burden on survival after adjusting for age, sex, and Child Pugh status. Results There was a significant increase in volumetric ADC (median, 15%; P < 0.001) and a decrease in volumetric arterial enhancement (AE) and VE (median AE, −43% and portal venous phase (PVP), −29%, respectively; P < 0.001) 3 to 4 weeks after treatment in the targeted tumor burden. Multivariable Cox regression demonstrated that both ADC response and low tumor burden were independently associated with greater survival (hazard ratios, 0.53 and 0.55; P values, 0.025 and 0.016, respectively) after adjustment for age, sex, and Child Pugh status. Multivariable Cox regression models demonstrated no statistically significant relationship between AE response and survival after adjusting for tumor burden. However, multivariable Cox regression demonstrated that VE response was associated with greater survival only in those with low tumor burden (hazard ratio, 0.10; P = 0.001), indicating a strong interaction between VE response and tumor burden. Conclusion Quantifying targeted tumor burden is important in predicting patient survival when using functional MRI metrics in assessing treatment response.

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confidence: 99%

Functional Magnetic Resonance Imaging Response of Targeted Tumor Burden and Its Impact on Survival in Patients With Hepatocellular Carcinoma

Corona‐Villalobos

Halappa

Bonekamp

et al. 2015

Investigative Radiology

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“…Recently, TACE for liver metastases via the hepatic artery was reported to be clinically efficacious[ 11 – 12 ]. Similar to primary liver cancer, the main blood vessel that supplies liver metastases is also a branch of the hepatic artery.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of transcatheter arterial chemoembolization for liver metastases arising from pancreatic cancer

et al. 2017

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PurposeThe aim of the study was to evaluate the efficacy of transcatheter arterial chemoembolization (TACE) in treating patients with liver metastases from pancreatic cancer, and explore the prognostic risk factors.ResultsThree of the 27 patients were totally recovered, and 12 were partially alleviated. The total efficacy rate was 55.6% (15/27). The median survival time was 13.6 months, and the 0.5-, 1-, 2-, 3-, and 5-year survival rates were 70.4% (19/27), 48.1% (13/27), 22.2% (6/27), 14.8 (4/27), 11.1% (3/27), respectively. None of the groups showed any severe complications. Univariate analysis showed that pathological type, concomitant therapies for liver metastasis, vascular supply, CA199 levels and extrahepatic metastasis were related to prognosis (P < 0.05). Multivariate analysis indicated that pancreatic cancer pathology and extrahepatic metastasis were independent risk factors influencing patients' prognosis (χ2 = 13.182, 17.989, P < 0.05).MethodsThe clinical records of 27 patients with lliver metastases from pancreatic cancer diagnosed at the First Affiliated Hospital of Zhejiang University between May 2009 and May 2015 were retrospectively analyzed. The short-term and long-term efficacy and toxic side effects of TACE were observed. The prognostic risk factors were analyzed using Cox (proportional hazards) regression model.ConclusionTACE is an effective therapy for treating liver metastases from pancreatic malignancy. Pathological type and extrahepatic metastasis of pancreatic tumor are independent risk factors for patients' prognosis. The prognosis of patients with liver metastasis from pancreatic neuroendocrine neoplasm is superior to that of extrahepatic metastasis.

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“…Additional data currently show that patients using a combination of TACE and LITT have better palliative treatment results; here, we achieved a median survival of 21.1 months [ 17 ].…”

Section: Resultsmentioning

confidence: 88%

“…Comparative indications for TACP and TACE allow a median survival of 21.1 months [ 17 ]. The data for the use of radioembolization are currently not conclusive.…”

Section: Resultsmentioning

confidence: 99%

How Effective Are Percutaneous Liver-Directed Therapies in Patients with Non-Colorectal Liver Metastases?

et al. 2015

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Background: The purpose of this review is to demonstrate the clinical indications, technical developments, and outcome of liver-directed therapies in interventional oncology of non-colorectal liver metastases. Methods: Liver-directed therapies are classified into vascular transarterial techniques such as chemoperfusion (TACP), chemoembolization (TACE), radioembolization (selective internal radiation therapy (SIRT)), and chemosaturation, as well as thermal ablation techniques like microwave ablation (MWA), radiofrequency ablation (RFA), laser-induced thermotherapy (LITT), cryotherapy, and irreversible electroporation (IRE). The authors searched the database PubMed using the following terms: ‘image-guided tumor ablation', ‘thermal ablation therapies', ‘liver metastases of uveal melanoma', ‘neuroendocrine carcinoma', ‘breast cancer', and ‘non-colorectal liver metastases'. Results: Various combinations of the above-mentioned therapy protocols are possible. In neuroendocrine carcinomas, oligonodular liver metastases are treated successfully via thermal ablation like RFA, LITT, or MWA, and diffuse involvement via TACE or SIRT. Although liver involvement in breast cancer is a systemic disease, non-responding nodular metastases can be controlled via RFA or LITT. In ocular or cutaneous melanoma, thermal ablation is rarely considered as an interventional treatment option, as opposed to TACE, SIRT, or chemosaturation. Rarely liver-directed therapies are used in pancreatic cancer, most likely due to problems such as biliary digestive communications after surgery and the risk of infections. Rare indications for thermal ablation are liver metastases of other primary cancers like non-small cell lung, gastric, and ovarian cancer. Conclusion: Interventional oncological techniques play a role in patients with liver-dominant metastases.

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Neoadjuvant TACE before laser induced thermotherapy (LITT) in the treatment of non-colorectal non-breast cancer liver metastases: Feasibility and survival rates

Cited by 11 publications

References 24 publications

Functional Magnetic Resonance Imaging Response of Targeted Tumor Burden and Its Impact on Survival in Patients With Hepatocellular Carcinoma

Functional Magnetic Resonance Imaging Response of Targeted Tumor Burden and Its Impact on Survival in Patients With Hepatocellular Carcinoma

Efficacy of transcatheter arterial chemoembolization for liver metastases arising from pancreatic cancer

How Effective Are Percutaneous Liver-Directed Therapies in Patients with Non-Colorectal Liver Metastases?

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