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Short-term effectiveness of radiochemoembolization for selected hepatic metastases with a combination protocol

World Journal of Gastroenterology 2012年第37期18卷 5249-5259页

作者： Shahram Akhlaghpoor Alireza Aziz-Ahari Mahasti Amoui Shahnaz Tolooee Hossein Poorbeigi shahab sheybani Department of Computed Tomography Noor Medical Imaging CenterSina HospitalTehran University of Medical Sciences Department of Radiology Sina HospitalTehran University of Medical Sciences Department of Nuclear Medicine Shohada-e-Tajrish Medical CenterShahid Beheshti University of Medical Sciences Nuclear Science and Technology Institute

AIM： To introduce the combination method of radio- chemoembolization for the treatment of selected he- patic metastases. METHODS： Twenty patients with biopsy proven hepat- ic metastases were selected from those who underwent transarterial radiochemoembolization, a novel combina- tion protocol, between .lanuary 2009 and July 2010. Patients had different sources of liver metastasis. The treatment included transarterial administration of three chemotherapeutic drugs （mitomycin, doxorubicin and cisplatin）, followed by embolization with large （50-150 μm） radioisotope particles of chromic 32R Multiphasic computer tomography or computer tomography stud- ies, with and without contrast medium injections, were performed for all patients for a short-term period before and after the treatment sessions. The short-term effec- tiveness of this procedure was evaluated by modified response evaluation criteria in solid tumors （mRECIST）, which also takes necrosis into account. The subjective percentage of necrosis was also assessed. The re- sponse evaluation methods were based on the changes in size, number, and the enhancement patterns of the lesions between the pre- and post-treatment imaging studies. RESULTS： Patients had liver metastasis from colorectal carcinomas, breast cancer, lung cancer and carcinoid tumors. The response rate based on the mRECIST criteria was 5% for complete response, 60% for par- tial response, 10% for stable disease, and 25% for progressive disease. Regarding the subjective necrosis percentage, 5% of patients had complete response, 50% had partial response, 25% had stable disease, and 20% had progressive disease. Based on traditional RECIST criteria, 3 patients （15%） had partial response, 13 patients （65%） had stable disease, and 4 patients （20%） had disease progression. In most patients, colorectal carcinoma was the source of metastasis （13 patients）. Based on the mRECIST criteria, 8 out of these 13 patients had partial responses, while one remained stable

关键词： Hepatic metastasis Radiochemoemboliza-tion Phosphorus radioisotopes Treatment Outcome

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