Hypoxic liver perfusion with mitomycin-C for treating multifocal metastases and unresectable primary tumours: a single-centre series of 42 patients
| Autor: | A, Bagliani, A, Baggiani, A M, Ierardi, B, Caspani, F, Motta, D, Toniolo, P, Belloni, E, Setola, E, Campagnoli, S, Tempini, R, Crocchiolo, M, Bregni, L, Belli |
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| Přispěvatelé: | Baggiani A., Ierardi A.M., Caspani B., Motta F., Toniolo D., Belloni P., Setola E., Campagnoli E., Tempini S., Crocchiolo R., Bregni M., Belli L. |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Liver perfusion medicine.medical_specialty Pathology Mitomycin Multifocal liver metastase Disease-Free Survival Hepatic Artery Retrospective Studie Medicine Humans Infusions Intra-Arterial Radiology Nuclear Medicine and imaging In patient Neoplasm Metastasis Neuroradiology Aged Retrospective Studies Inpatients Antibiotics Antineoplastic medicine.diagnostic_test business.industry digestive oral and skin physiology Mitomycin C Liver Neoplasms Interventional radiology General Medicine Liver tumours Length of Stay Middle Aged Cell Hypoxia Feasibility Studie Neoplasm Metastasi Radiography Single centre Hypoxic liver perfusion Treatment Outcome Liver Neoplasm Toxicity Quality of Life Mitomycin-C Feasibility Studies Female Radiology Inpatient business Human |
| Zdroj: | La Radiologia medica. 116(8) |
| ISSN: | 1826-6983 |
| Popis: | Purpose: The purpose of our study was to retrospectively evaluate the feasibility, toxicity and impact on overall (OS) and disease-free (DFS) survival of intra-arterial liver perfusion with mitomycin-C (MMC) [hypoxic liver perfusion with MMC (HLPM)] in patients with multifocal liver metastases or with unresectable primary liver tumours. Materials and methods: Forty-two patients underwent 56 intra-arterial liver infusions with MMC between June 2001 and May 2009. The patients presented specific characteristics, i.e. they were all refractory to locoregional (LR) and/or systemic treatments. HLPM consists of selective catheterisation of the common hepatic artery, permanent occlusion of the gastroduodenal artery at its origin using metal coils, an inflated balloon catheter placement at the origin of the proper hepatic artery to block blood flow and induce hypoxia for around 10 min, MMC infusion and vascular-bed occlusion through injection of an absorbable haemostatic agent. During the procedure, the patients received anaesthesiological monitoring. Biochemical and morphological responses were evaluated, as were haematological, hepatic and systemic toxicity. Results: Patients were hospitalised for 10 days on average (range 7-15). Side effects were liver toxicity in all cases, acute pancreatitis in one case and liver failure in one case. Computed tomography performed at 30 days documented a partial response (PR) in 29%, stable disease (SD) in 45% and progressive disease (PD) in 26% of patients. The response lasted 4 months on average (range 3-6). Mean overall survival (OS) was 20 months for all patients, reaching 30 months in those with colorectal carcinoma. Conclusions: The procedure is feasible, and treatmentrelated toxicity and mortality rates are acceptable. It may be considered a palliative treatment option in patients with advanced liver disease in centres with adequately experienced medical teams. © 2011 Springer-Verlag Italia. |
| Databáze: | OpenAIRE |
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