Arterial Embolization Using Microspheres for Hypervascular Liver Metastases Refractory to Standard Treatments: A Multice
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Arterial Embolization Using Microspheres for Hypervascular Liver Metastases Refractory to Standard Treatments: A Multicenter Prospective Clinical Trial Masashi Shimohira1 • Yozo Sato2 • Taku Yasumoto3 • Yoshihisa Kodama4 Tetsuya Masada5 • Yoshitaka Inaba2 • Koichiro Yamakado6
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Received: 17 June 2020 / Accepted: 29 September 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To evaluate the clinical utility of bland arterial embolization using microspheres in patients with hypervascular liver metastases refractory to standard treatments. Materials and Methods Primary endpoints of this prospective single-arm non-comparative study were objective response and disease control rates (ORR and DCR), based on the modified Response Evaluation Criteria in Solid Tumors at 4 weeks after embolization. Secondary endpoints were ORR according to primary tumor, overall survival, progression-free survival (PFS), and safety. Results Twenty-five patients with a median age of 66 years (range, 40–95 years) were enrolled in this study. The median maximum diameter of liver metastasis was 3.7 cm (range, 2.0–15.2 cm). Primary lesions were colorectal cancer in 12 patients (48%, 12/25), other cancer in 7 (28%, 7/25), neuroendocrine tumor in 4 (16%, 4/25), and sarcoma in 2 (8%, 2/25). ORR and DCR were 52% (13/25)
& Masashi Shimohira [email protected] 1
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
2
Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
3
Department of Interventional Radiology, Miyakojima IGRT Clinic, Osaka 534-0021, Japan
4
Department of Radiology, Teine Keijinkai Hospital, Sapporo 006-0811, Japan
5
Department of Radiology, Nara Medical University, Kashihara 634-8521, Japan
6
Department of Radiology, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
and 72% (18/25) in all patients, 42% (5/12) and 75% (9/12) in colorectal cancer patients, and 62% (8/13) and 69% (9/ 13) in other malignant tumor patients (p = 0.43, p [ 0.99). Median survival time was 19 months in all patients, 19 months in colorectal cancer patients, and 8 months (p = 0.16) in other malignant tumor patients. Median PFS time was 4 months in all patients, 4 months in colorectal cancer patients, and 6 months (p = 0.0085) in other malignant tumor patients. There were no grade-3 or -4 adverse events. Conclusion Microsphere embolization appears to be an effective and safe treatment for hypervascular liver metastases refractory to standard treatments. Keywords Bland arterial embolization Microspheres Liver metastases
Introduction The liver is a common organ of metastasis for various malignant tumors [1]. When liver metastasis left untreated, the median survival time for patients was ranged 3–8 months [2–4]. Although hepatectomy is considered the gold standard t
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