Transcatheter arterial chemoembolization or chemoinfusion for unresectable intrahepatic cholangiocarcinoma

Kim, Jin Hyoung; Yoon, Hyun Ki; Sung, Kyu Bo; Ko, Gi Young; Gwon, Dong Il; Shin, Ji Hoon; Song, Ho Young

doi:10.1002/cncr.23787

Cited by 106 publications

(56 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study of Kim et al 48 showed that hypovascular tumor, Child-Pugh class B and large tumor size were poor prognostic factors for patient's survival, there the median and mean survival times were 10 and 18 months after TACE or chemoinfusion with Cisplatin. The survival rates were 52% at 1 year, 38% at 2 years and 16% at 3 years.…”

Section: Cancer Therapymentioning

confidence: 99%

Transarterial chemoembolization in the treatment of patients with unresectable cholangiocarcinoma: Results and prognostic factors governing treatment success

Vogl

Naguib

Nour-Eldin

et al. 2011

Intl Journal of Cancer

126

View full text Add to dashboard Cite

The aim of the study was to evaluate the effectiveness of transarterial chemoembolization (TACE) with four chemotherapeutic protocols in terms of local tumor control and survival of patients with unresectable cholangiocarcinoma (CCC) and to identify the prognostic factors governing treatment success. In the single-centre study, 115 patients (mean ages 5 60.4 years) with unresectable CCC were repeatedly treated with TACE. In total, 819 chemoembolization sessions were performed in 4 week intervals with a mean of 7.1 (range, 3-30) sessions per patient. The chemotherapeutic used was Mitomycin C only in 20.9% of patients, Gemcitabine only in 7%, Mitomycin C with Gemcitabine in 47% and combination of Gemcitabine, Mitomycin C and Cisplatin in 25.1%. Local tumor response was evaluated by MRI according to RECIST. Survival data were calculated according to the Kaplan-Meier method. Prognostic factors for patient's survival were evaluated using log-rank-test. The local tumor controls were: partial response 8.7%, stable disease 57.4% and progressive disease 33.9% of patients. The median and mean survival times from the start of TACE were 13 and 20.8 months. Survival rate from the start of TACE was 52% after 1-year, 29% after 2-years and 10% after 3-years. Initial tumor response, high tumor vascularity and Child-Pugh class A were statistically significant factors for patient's survival. No statistically significant difference between patients treated with different chemotherapy protocols was noted. In conclusion, TACE is a palliative and safe treatment option for patients with unresectable CCC. Child Pugh class B, tumor hypovascularity and initially progressive disease were poor prognostic factors for patient survival.Cholangiocarcinoma (CCC) is the second most common primary hepatic malignancy following hepatocellular carcinoma. 1 The tumor represents less than 2-3% of all cancers and up to 19% of primary liver cancers worldwide. [1][2][3][4] In Europe and North America, the average incidence of CCC is 1-2/100,000 per year. 5,6 The incidence during the last years is increasing, and this increasing incidence is associated with an increase in mortality. 2,7-10 Because of an advanced nature of the tumor on the time of first diagnosis, the therapeutic options for patients with unresectable CCC are limited.Transarterial chemoembolization (TACE) is a local, catheter-based, minimally invasive therapeutic option for unresectable liver tumors, and is defined as a selective administration of chemotherapy usually combined with embolization of the vascular supply of the tumor. 11 For patients with liver tumors, TACE, as a combination of local-arterial application of chemotherapeutic drugs with additional usage of embolization particles, is an effective and recommended treatment. The concept of TACE has been used in the management of patients with liver metastases from colorectal cancer, breast carcinoma as well as patients with unresectable hepatocellular carcinoma (HCC). [12][13][14][15][16][17] Regarding unresectable CCC there are few...

show abstract

Section: Cancer Therapymentioning

confidence: 99%

Transarterial chemoembolization in the treatment of patients with unresectable cholangiocarcinoma: Results and prognostic factors governing treatment success

Vogl

Naguib

Nour-Eldin

et al. 2011

Intl Journal of Cancer

126

View full text Add to dashboard Cite

show abstract

“…First, details regarding tumor vascularity on angiography in all patients were not provided. In our previous report [2], the tumor blush was not identified on angiography in 26% (13/49) of the patients with intrahepatic cholangiocarcinoma. Trancatheter arterial chemoinfusion was performed for these patients because it is not easy to decide whether to perform embolization of the right or left hepatic artery or the segmental artery despite the possible embolization-related complications.…”

Section: To the Editormentioning

confidence: 72%

“…Generally, tumor size and reserved liver functions are important factors for survival period in patients who undergo palliative therapy for hepatic malignancy [2,3]. Therefore, significant selection bias might not have been eliminated in their study.…”

Section: To the Editormentioning

confidence: 99%

Comments on “Chemoembolization (TACE) of Unresectable Intrahepatic Cholangiocarcinoma with Slow-Release Doxorubicin-Eluting Beads: Preliminary Results”

Kim

2009

Cardiovasc Intervent Radiol

Self Cite

View full text Add to dashboard Cite

“…Target methods, aiming to direct the treatment locally inside the tumor, are valid alternatives to systemic chemotherapy for unresectable CCA, including thermal ablation with radiofrequency ablation or microwave ablation, and chemoembolization (21)(22)(23). Figure …”

Section: Discussionmentioning

confidence: 99%

“…TACE can be performed using several drugs, such as gemcitabine, mitomycin C and doxorubicin (23,24).…”

Section: Effects Of Transarterial Chemoembolization (Tace) On Intramentioning

confidence: 99%

Chemoembolization with Drug-eluting Microspheres Loaded with Doxorubicin for the Treatment of Cholangiocarcinoma

2017

View full text Add to dashboard Cite

Abstract. Aim: To report clinical outcomes of transarterial chemoembolization (TACE) using drug-eluting beads (DEBs) loaded with doxorubicin for the treatment of unresectable intrahepatic cholangiocarcinoma (CCA). Patients and Methods: We treated 127 patients with doxorubicin via TACE. Inclusion criteria were: diagnosis of unresectable CCA; indication for TACE, performance status (PS) 0-2, >3 months of life expectancy, >18 years old, written consent. TACE was performed using DEBs for 109 (86%) patients and polythylene glycol drug-elutable microspheres (PEG) loaded with doxorubicin for 18 (14%) patients. Results: Tumor response of the whole sample of 127 patients was partial response (PR) in 19 (15%) patients, stable disease (SD) in 101 (80%) and progressive disease (PD) in seven (5%) 3 months after therapy, with no complete responses.There were differences between type of embolics: PR was 7% and 77%, SD was 88% and 8%, and PD was 5% and 15%, and the disease control rate was 95% and 85% in the DEB and PEG groups, respectively. Most frequent side-effects were: abdominal pain, fever, nausea, and transaminase rise. Conclusion: TACE was effective and safe for CCA treatment, with a high disease control rate. The best response of PEG-TACE was PR, whereas it was SD for DEB-TACE.About 10% of primary hepatic cancer is represented by cholangiocarcinoma (CCA), with a preferential distribution among men rather than women (1). CCA classification includes intrahepatic, perihilar and distal extrahepatic cancer (galbladder or coledocus). These groups have different biological characteristics, clinical diagnoses, and treatment management (2).Known risk factors for CCA include chronic inflammation, and injury of the bile tract, biliary lithiasis, and other novel risk factors such as obesity and hepatitis C virus infection (3). Over the past decades, CCA incidence and mortality has been increasing in Europe (4).Surgery is considered the only curative option for CCA, however, it is possible only for 27-30% of patients (5). Unresectable CCA has a poor prognosis, with a median survival of 3-6 months (6, 7). Systemic chemotherapy aims to reduce tumor growth and symptoms, and to improve the quality of life of patients with unresectable CCA, however, its benefits are poor, leading to an overall survival of about 1 year (8, 9). The combination of systemic chemotherapy with capecitabine and intra-arterial administration of toxic drugs is increasingly being used (10-12).Transarterial chemoembolization (TACE) allows the delivery of high concentration of chemotherapy selectively to the liver, in association with the embolization of the arteries afferent to the tumor (13-18). This method is achieving encouraging results in patients with CCA. Several studies with TACE for the therapy of unresectable CCA include mixed intrahepatic and extrahepatic CCA populations of only a small number of patients, for this reason it is difficult to have clear results on its efficacy. The purpose of this study was to report clinical outcomes of treatments of ...

show abstract

Transcatheter arterial chemoembolization or chemoinfusion for unresectable intrahepatic cholangiocarcinoma

Cited by 106 publications

References 36 publications

Transarterial chemoembolization in the treatment of patients with unresectable cholangiocarcinoma: Results and prognostic factors governing treatment success

Transarterial chemoembolization in the treatment of patients with unresectable cholangiocarcinoma: Results and prognostic factors governing treatment success

Comments on “Chemoembolization (TACE) of Unresectable Intrahepatic Cholangiocarcinoma with Slow-Release Doxorubicin-Eluting Beads: Preliminary Results”

Chemoembolization with Drug-eluting Microspheres Loaded with Doxorubicin for the Treatment of Cholangiocarcinoma

Contact Info

Product

Resources

About