Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature

Tellez, Claudia; Benson, Al B.; Lyster, Michael T.; Talamonti, Mark S.; Shaw, John M.; Braun, Marina; Nemcek, Albert A.; Vogelzang, Robert L.

doi:10.1002/(sici)1097-0142(19980401)82:7<1250::aid-cncr7>3.0.co;2-j

Cited by 174 publications

(78 citation statements)

References 51 publications

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“…However, the impact of embolization on the patency of arteries directly responsible for feeding the tumor has not been evaluated. Whereas some studies have reported excellent results with embolization alone (mostly against neuroendocrine tumors), others support the use of chemotherapy as a part of a cocktail, containing an oily vehicle and embolic particles, delivered to the tumor [6,25,26].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Arterial Chemoembolization of Liver Tumors: Effects of Embolization Protocol on Injectable Volume of Chemotherapy and Subsequent Arterial Patency

Geschwind

Ramsey

Cleffken

et al. 2003

CardioVascular and Interventional Radiology

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The purpose of this study was to determine whether transcatheter arterial chemoembolization (TACE) protocol affects the total volume of chemotherapy injected into the liver as well as subsequent arterial patency. A total of 160 patients with primary or secondary liver cancer were treated with 3 different chemoembolization protocols at a single institution. Data were analyzed retrospectively. Group 1 (n ϭ 36) consisted of slurry of chemotherapy, oil and polyvinyl alcohol particles (PVA), group 2 (n ϭ 91), chemotherapy and oil followed by PVA, and group 3 (n ϭ 33), chemotherapy and oil followed by Gelfoam pledgets. The total volume of chemotherapy injected into the liver was recorded. Arterial patency was determined during subsequent chemoembolizations. The mean percentage of total intended chemotherapy dose administered was 54.6% for group 1, 75.3% for group 2, and 80.6% for group 3. Arterial patency at follow-up angiography was 56% for group 1, 74% for group 2, and 81% for group 3. The slurry protocol (group 1) significantly reduced arterial patency and injectable volume of chemotherapy during TACE.

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Section: Discussionmentioning

confidence: 99%

Transcatheter Arterial Chemoembolization of Liver Tumors: Effects of Embolization Protocol on Injectable Volume of Chemotherapy and Subsequent Arterial Patency

Geschwind

Ramsey

Cleffken

et al. 2003

CardioVascular and Interventional Radiology

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“…As in neuroendocrine patients, the absence of underlying cirrhosis reduces the expected morbidity. Chemoembolization for patients with metastatic colorectal cancer appears to be a reasonable alternative for many who are not surgical candidates [109][110][111][112][113][114][115][116]. Survival may be especially enhanced in treated patients who have no extrahepatic metastases [117].…”

Section: Colorectal Metastasesmentioning

confidence: 68%

Chemoembolization in the Management of Liver Tumors

Stuart

2003

The Oncologist

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The dual vascular supply of the liver affords a unique opportunity to explore intraarterial therapies for hepatic malignancies. Chemoembolization is a well-established technique combining intra-arterial chemotherapy with delivery of embolic agents in order to achieve an antitumor effect due to a high local concentration and prolonged dwell time of the drug, along with select ischemia. Many tumors, such as hepatocellular carcinoma, colorectal cancer, and neuroendocrine tumors, cause symptoms and death by local growth and destruction of the liver.While there are other methods capable of controlling small or isolated hepatic neoplasms, none are suitable for the majority of these patients. Chemoembolization can produce significant results in terms of tumor shrinkage in many of these patients, and there are studies to suggest a survival advantage in hepatocellular carcinoma. Toxicity, however, may be substantial, and patient selection is crucial in order to achieve the optimal benefit of this powerful technique for individual populations. The Oncologist 2003;8:425-437 The Oncologist 2003;8:425-437 www.TheOncologist.com

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“…To date, embolization was achieved either with encoated drugs (microcapsules) (Kato et al, 1996) or with concomitant delivery of embolizing substances like polyvinyl alcohol, lipiodol, albumine, degradable starch microspheres using mixtures, sometimes with several drugs (Tellez et al, 1998;Vogl et al, 2000;Yamamoto et al, 2000). These protocols have certain advantages: microcapsules provide good reproducibility of the product with good control of particle diameter, and a pharmacologically adjusted time of drug release.…”

Section: Discussionmentioning

confidence: 99%

“…At concentrations higher than 1 mg ml 71 precipitation occurs and cisplatin is not dissolved totally. The use of a concentrated injection seemed justified for two reasons: the absolute dose of cisplatin remained the same as in the well established settings of intra-arterial chemotherapy of more than 300 head and neck cancer patients (Kovács et al, 1999;Robbins et al, 2000), and highly concentrated mixtures of cisplatin with embolizing agents with same or larger particle diameters were used for decades in the treatment of patients with liver cancer and metastases (Tellez et al, 1998;Yamamoto et al, 2000). The high concentrations up to 10 mg cisplatin in 1 ml lipiodol (Yamamoto et al, 2000) or other embolizing agents were empirically motivated and had no pharmacological foundation.…”

Section: Clinicalmentioning

confidence: 99%

Monocomponent chemoembolization in oral and oropharyngeal cancer using an aqueous crystal suspension of cisplatin

Kovács

Obitz

2002

Br J Cancer

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Intensification of intra-arterial chemotherapy with high-dose cisplatin and concomitant reduction of toxicity under the conditions of the head and neck was aimed at by combination of antineoplastic activity and embolizing effect in the same pharmacon. A cisplatin suspension in normal saline (5 mg in 1 ml) with precipitation of microembolizing cisplatin crystals was prepared. No additional pharmacons. Cisplatin dosage was 150 mg m 72 , maximum absolute dose 300 mg, maximum amount of fluid 60 ml. Thirty patients (UICC-Classification of tumours: I/2 patients, II/6, III/2; IV/20) were treated in a neoadjuvant setting with superselective chemoembolization using the cisplatin suspension. A control group (n=30) with the same tumour and nodal staging was treated with a usual cisplatin solution (150 mg m 72 dissolved in 500 ml saline). In both groups, parallel intravenous infusion of sodium thiosulphate (9 g m 72 ). Endpoints were toxicity and response. Continuation of treatment by surgery or radiation. Overall remission was 70% in the study group and 46.7% in the control group after one cycle respectively. Systemic side-effects were very low (grade I WHO) in both groups. Side-effects were found to be similar to post-embolization syndrome (swelling, mild to moderate pain, leucocytosis without fever) in the study group. Chemoembolization in the head and neck area can be carried out routinely using this method.

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Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature

Cited by 174 publications

References 51 publications

Transcatheter Arterial Chemoembolization of Liver Tumors: Effects of Embolization Protocol on Injectable Volume of Chemotherapy and Subsequent Arterial Patency

Transcatheter Arterial Chemoembolization of Liver Tumors: Effects of Embolization Protocol on Injectable Volume of Chemotherapy and Subsequent Arterial Patency

Chemoembolization in the Management of Liver Tumors

Monocomponent chemoembolization in oral and oropharyngeal cancer using an aqueous crystal suspension of cisplatin

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