Embolization of hepatocellular carcinoma with drug-eluting beads: doxorubicin tissue concentration and distribution in patient liver explants
| Autor: | Mark H. Dupuis, Marty Sellers, Julien Namur, Alexandre Laurent, Michel Manfait, Michel Wassef, Steven J. Citron |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Necrosis Carcinoma Hepatocellular medicine.medical_treatment Liver transplantation medicine Humans Doxorubicin In patient Tissue Distribution Embolization Chemoembolization Therapeutic IC50 Aged Antibiotics Antineoplastic Hepatology business.industry Liver Neoplasms Middle Aged medicine.disease Microspheres Liver Transplantation Liver Hepatocellular carcinoma Delayed-Action Preparations Female medicine.symptom business medicine.drug Explant culture |
| Zdroj: | Journal of hepatology. 55(6) |
| ISSN: | 1600-0641 |
| Popis: | Background & Aims To follow the local tissue delivery of doxorubicin in HCC explants from patients embolized with drug-eluting beads and to compare it with histologic modifications. Methods Six patients with HCC underwent chemoembolization with doxorubicin-eluting beads (caliber 100–300μm, dose 75–150mg) followed by liver transplantation at different time points (8h to 36days). On sections of the explanted liver, the tissue concentration of doxorubicin was determined radially around bead-occluded vessels with microspectrofluorimetry. The intra/peritumoral location of the beads and the modifications of the surrounding tissue were determined on an adjacent hematein–eosin–saffron-stained section and compared to drug measurements. Results Doxorubicin was detected in the tissue surrounding the beads at all times of explantation. The drug impregnates an area of at least 1.2mm in diameter around the occluded vessel. The tissue concentration of drug ranges from 5μM at 8h to 0.65μM at 1 month. In patient transplanted at 8h, no major tissue modification was observed and we found 42% of the beads occluding intratumoral vessels. Drug concentration was not different around intratumoral and peritumoral occluded vessels. After 9–14days, necrosis was present around 37% of vessels and at 32–36days, around 40% of vessels. Necrotic tissue was associated with a deeper penetration and a higher concentration of the drug than non necrotized areas, though statistically significant only at 32–36days. Conclusions Doxorubicin-eluting beads provide a sustained delivery of drug for a period of 1 month and local tissue concentrations above cytotoxic threshold in HCC-bearing livers. |
| Databáze: | OpenAIRE |
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