Image-Guided Transarterial Chemoembolization With Drug-Eluting Beads Loaded with Doxorubicin (DEBDOX) for Unresectable Hepatic Metastases from Melanoma: Technique and Outcomes
| Autor: | Robert C.G. Martin, Cliff Tatum, Kelly M. McMasters, Takami Sato, Larry Kelly, Alda L. Tam, Jack W. Rostas, Charles R. Scoggins |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Skin Neoplasms Disease-Free Survival 030218 nuclear medicine & medical imaging Metastasis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Doxorubicin Prospective Studies Chemoembolization Therapeutic Prospective cohort study Melanoma Aged business.industry Liver Neoplasms Cancer Middle Aged medicine.disease Microspheres Treatment Outcome Response Evaluation Criteria in Solid Tumors 030220 oncology & carcinogenesis Concomitant Toxicity Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | CardioVascular and Interventional Radiology. 40:1392-1400 |
| ISSN: | 1432-086X 0174-1551 |
| DOI: | 10.1007/s00270-017-1651-z |
| Popis: | Hepatic metastasis from melanoma represents a therapeutic dilemma, with limited effective options for the 85% of cases deemed unresectable. Systemic agents confer toxicity and, along with traditional local hepatic arterial-directed therapies such as transarterial chemoembolization, have not led to a significant increase in survival. The aim of this study was to investigate the safety and dose-limiting toxicity of DEBDOX for the treatment of unresectable hepatic metastases from melanoma. A multicenter (University of Louisville, Thomas Jefferson University, MD Anderson Cancer Center), prospective, non-controlled treatment trial (NCT01010984) of hepatic-directed therapy with DEBDOX for the treatment of melanoma liver metastasis was reviewed. Primary endpoints were response rates by modified response evaluation criteria in solid tumors, hepatic progression-free survival (PFS), and overall survival (OS). Twenty patients received a total of 61 DEBDOX treatments from January 2010 to March 2013. The median hepatic tumor burden was 40% (range 20–55), 18 patients (90%) had bilobar disease, and 13 patients (65%) had concomitant extrahepatic disease. At median assessment of 2.5 months, 11 patients (55%) exhibited a tumor response and 16 (80%) exhibited disease control. Median follow-up was 5 months (range 1.1–34.3 months). Median hepatic PFS was 3 months (95% CI 1.4, 3.4), and OS was 5 months (95% CI 3.3, 10.5). Directed arterial therapy with DEBDOX is effective in managing unresectable liver-dominant metastasis from melanoma and should be considered a therapeutic option in the multidisciplinary treatment of this disease. Concurrent systemic therapy is merited given the high rate of extrahepatic progression. NCT01010984. |
| Databáze: | OpenAIRE |
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