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Chemoembolization with microspheres in liver tumors

R Gallicchio, A Nardelli, P Mainenti, A Nappi, D Capacchione, V Simeon, C Sirignano, F Abbruzzi, F Barbato, M Landriscina, G Storto
Patients with hepatocellular carcinoma (HCC) comply with an advanced disease and are not eligible for radical therapy. In this distressed scenario new treatment options hold great promise; among them transarterial chemoembolization (TACE) and transarterial metabolic radiotherapy (TAMR) have shown efficacy in terms of both tumor shrinking and survival. External radiation therapy (RTx) by using novel three-dimensional conformal radiotherapy has also been used for HCC patients with encouraging results while its role had been limited in the past for the low tolerance of surrounding healthy liver...
2016: BioMed Research International
R Iezzi, M Pompili, M Nestola, M Siciliano, E Annicchiarico, M A Zocco, E Rinninella, A Posa, G E M Antonuccio, A Gasbarrini, L Bonomo
OBJECTIVE: To assess safety, feasibility and effectiveness of transarterial chemoembolization with degradable-starch-microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (Sorafenib) due to unbearable side effects or clinical contraindications. PATIENTS AND METHODS: Six consecutive advanced HCC patients dismissing Sorafenib because of unbearable side effects or worsened clinical conditions were enrolled in our prospective single-center pilot study...
July 2016: European Review for Medical and Pharmacological Sciences
Smit Singla, Charles M LeVea, Venkata K Pokuri, Kristopher M Attwood, Michael M Wach, Garin M Tomaszewski, Boris Kuvshinoff, Renuka Iyer
BACKGROUND: Neuroendocrine tumors (NETs) metastatic to the liver are treated with transarterial radioembolization (TARE) using yttrium-90 (Y-90) microspheres or transarterial chemoembolization (TACE). However the criteria for patient selection are not well defined. We sought to determine if Ki67 score could help select patients for one therapy over the other in the management of hepatic neuroendocrine metastases. METHODS: Single institution analysis of patients treated with Y-90 or TACE between 2001 and 2014...
June 2016: Journal of Gastrointestinal Oncology
Jun Qian, Elsie Oppermann, Andreas Tran, Ulli Imlau, Kun Qian, Thomas Josef Vogl
AIM: To compare the effect of transarterial chemoembolization (TACE) plus GRGDSP (Gly-Arg-Gly-Asp-Ser-Pro, integrin-inhibitor) loaded nanoparticles with TACE alone or TACE + GRGDSP in a rat model of liver tumor. METHODS: Morris hepatoma 3924A tumors were implanted in the livers of 30 ACI rats. The ACI rats were divided randomly into three groups (10 animals each). Tumor volume before treatment (V1) was examined by magnetic resonance imaging (MRI), and then, after laparotomy and placement of a PE-10 catheter into the hepatic artery, the following interventional protocols were performed: TACE (mitomycin C + lipiodol + degradable starch microspheres) + GRGDSP loaded nanoparticles for group A; TACE + GRGDSP for group B (control group 1); TACE alone for group C (control group 2)...
June 7, 2016: World Journal of Gastroenterology: WJG
Andreas H Mahnken
Unresectable primary and secondary liver malignancies present a major problem in the treatment of solid tumors. Transarterial radioembolization (TARE) is an increasingly used technique for treating various types of malignant liver tumors. This approach is appealing, as the mechanism of action is independent from other loco-regional treatments and potentially complementary to systemic therapies. There are two commercially available products in use for TARE: (90)Y-resin and (90)Y-glass microspheres. Currently available data indicates TARE so be safe and effective in hepatocellular carcinoma (HCC) and metastatic liver disease...
May 28, 2016: World Journal of Radiology
Joseph Ralph Kallini, Ahmed Gabr, Riad Salem, Robert J Lewandowski
BACKGROUND: Hepatocellular carcinoma (HCC) is a common cause of worldwide mortality. Transarterial radioembolization (TARE) with yttrium-90 (Y90), a transcatheter intra-arterial procedure performed by interventional radiology, has become widely utilized in managing HCC. METHODS: The following is a focused review of TARE covering its commercially available products, clinical considerations of treatment, salient clinical trial data establishing its utility, and the current and future roles of TARE in the management of HCC...
May 2016: Advances in Therapy
Jonathan M Loree, Tadaaki Hiruki, Hagen F Kennecke
BACKGROUND: Management options for pancreatic neuroendocrine tumors (pNETs) metastatic to the liver include surgical, ablative, cytotoxic, and radioisotope approaches. One potential local treatment option includes selective internal radiotherapy utilizing yttrium-90 ((90)Y) microspheres. (90)Y has also been used in the treatment of hepatocellular carcinoma and tumors metastatic to the liver. It appears to be well tolerated; however, there is no randomized controlled trial reporting long-term toxicities...
January 2016: Case Reports in Oncology
Karen T Brown, Richard K Do, Mithat Gonen, Anne M Covey, George I Getrajdman, Constantinos T Sofocleous, William R Jarnagin, Michael I D'Angelica, Peter J Allen, Joseph P Erinjeri, Lynn A Brody, Gerald P O'Neill, Kristian N Johnson, Alessandra R Garcia, Christopher Beattie, Binsheng Zhao, Stephen B Solomon, Lawrence H Schwartz, Ronald DeMatteo, Ghassan K Abou-Alfa
PURPOSE: Transarterial chemoembolization is accepted therapy for hepatocellular carcinoma (HCC). No randomized trial has demonstrated superiority of chemoembolization compared with embolization, and the role of chemotherapy remains unclear. This randomized trial compares the outcome of embolization using microspheres alone with chemoembolization using doxorubicin-eluting microspheres. MATERIALS AND METHODS: At a single tertiary referral center, patients with HCC were randomly assigned to embolization with microspheres alone (Bead Block [BB]) or loaded with doxorubicin 150 mg (LC Bead [LCB])...
June 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Takahiko Tanigawa, Yasunori Hasuike, Yousuke Akiyama, Ichiro Higuchi, Akira Ishikawa, Atsuya Okada, Makoto Miyamoto
The patient was an 83-year-old man who underwent distal gastrectomy for gastric cancer (T3, N1, M0, P0, M0, stage ⅡB) at a different hospital from ours. A metastatic lesion was detected in the liver 5 months after gastrectomy. Although chemotherapy with S-1 or bi-weekly CPT-11 was administered for 6 months, the liver tumor increased in size. The patient was referred to our hospital for treatment of the liver metastasis. Abdominal-computed tomography (CT) and magnetic resonance imaging (MRI) revealed a solitary metastatic liver tumor (9 cm in diameter: S7/S6/S8) with a hypervascular tumor stain...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Antonio Orlacchio, Fabrizio Chegai, Stefano Merolla, Simona Francioso, Costantino Del Giudice, Mario Angelico, Giuseppe Tisone, Giovanni Simonetti
AIM: To evaluate the downstaging rates in hepatitis C virus-patients with hepatocellular carcinoma (HCC), treated with degradable starch microspheres transcatheter arterial chemoembolization (DSM-TACE), to reach new-Milan-criteria (nMC) for transplantation. METHODS: This study was approved by the Ethics Committee of our institution. From September 2013 to March 2014 eight patients (5 men and 3 women) with liver cirrhosis and multinodular HCC, that did not meet nMC at baseline, were enrolled in this study...
June 28, 2015: World Journal of Hepatology
Su Jong Yu, Yoon Jun Kim
Patients with hepatocellular carcinoma (HCC) accompanying portal vein tumor thrombosis (PVTT) have relatively few therapeutic options and an extremely poor prognosis. These patients are classified into barcelona clinic liver cancer stage C and sorafenib is suggested as the standard therapy of care. However, overall survival (OS) gain from sorafenib is unsatisfactory and better treatment modalities are urgently required. Therefore, we critically appraised recent data for the various treatment strategies for patients with HCC accompanying PVTT...
June 18, 2015: World Journal of Hepatology
Rodolfo Sacco, Valeria Mismas, Sara Marceglia, Antonio Romano, Luca Giacomelli, Marco Bertini, Graziana Federici, Salvatore Metrangolo, Giuseppe Parisi, Emanuele Tumino, Giampaolo Bresci, Ambra Corti, Manuel Tredici, Michele Piccinno, Luigi Giorgi, Carlo Bartolozzi, Irene Bargellini
In the last decade trans-arterial radioembolization has given promising results in the treatment of patients with intermediate or advanced stage hepatocellular carcinoma (HCC), both in terms of disease control and tolerability profile. This technique consists of the selective intra-arterial administration of microspheres loaded with a radioactive compound (usually Yttrium(90)), and exerts its therapeutic effect through the radiation carried by these microspheres. A careful and meticulous selection of patients is crucial before performing the radioembolization to correctly perform the procedure and reduce the incidence of complications...
June 7, 2015: World Journal of Gastroenterology: WJG
Jin Woo Choi, Ju-Hwan Park, Song Yi Baek, Dae-Duk Kim, Hyo-Cheol Kim, Hyun-Jong Cho
Doxorubicin (DOX)-loaded poly(lactic-co-glycolic acid) (PLGA) microspheres (MSs) were fabricated using the solid-in-oil-in-water (S/O/W) emulsification method for transarterial chemoembolization (TACE) of a liver tumor. DOX-loaded PLGA MSs with a mean diameter of 26 μm and a spherical shape were prepared. The biodegradation of PLGA MSs was observed in serum using a scanning electron microscope (SEM). Drug release from the PLGA MSs was accelerated at an acidic pH (pH 5.5) compared to a normal physiological pH (pH 7...
August 1, 2015: Colloids and Surfaces. B, Biointerfaces
Jeane Chen, Sarah B White, Kathleen R Harris, Weiguo Li, Jonathan W T Yap, Dong-Hyun Kim, Robert J Lewandowski, Lonnie D Shea, Andrew C Larson
Transcatheter arterial embolization and chemoembolization are standard locoregional therapies for hepatocellular carcinoma (HCC). However, these can result in tumor hypoxia, thus promoting tumor angiogenesis. The anti-angiogenic agent sorafenib is hypothesized to improve outcomes; however, oral administration limits patient tolerance. Therefore, the purpose of this study was to fabricate poly(lactide-co-glycolide) microspheres for local sorafenib delivery to tumors during liver-directed embolotherapies. Iron oxide nanoparticles (IONP) were co-encapsulated for magnetic resonance imaging (MRI) of microsphere delivery...
August 2015: Biomaterials
A V Skupchenko, A V Lysenko, D G Korolev, D A Skobel'tsov, A S Rassudishkin
OBJECTIVE: To evaluate the efficiency of chemoembolization using irinotecan-loaded DC Bead microspheres in the second-line chemotherapy for colorectal liver metastases. MATERIAL AND METHODS: In 2008 to 2013, thirty-two patients with unresectable colorectal liver metastases underwent 78 chemoembolizations (mean 2.44 per patient). The results of embolization were assessed by computed tomography using the Response Evaluation Criteria in Solid Tumors (RECIST) criteria...
November 2014: Vestnik Rentgenologii i Radiologii
Andreas H Mahnken
Unresectable liver cancer presents a major problem in the treatment of solid tumors. Transarterial radioembolization is a modern approach toward primary and secondary liver malignancies. The mechanism of action is independent from other therapies that are based on ischemia or chemotoxicity. (90)Y-resin and (90)Y-glass microspheres are commercially available for transarterial radioembolization. Available data on the use of (90)Y-glass microspheres in hepatocellular carcinoma and metastatic disease indicate that this treatment is safe and effective...
2015: Future Oncology
Yì-Xiáng J Wáng, Thierry De Baere, Jean-Marc Idée, Sébastien Ballet
Transarterial chemoembolization (TACE) is a form of intra-arterial catheter-based chemotherapy that selectively delivers high doses of cytotoxic drug to the tumor bed combining with the effect of ischemic necrosis induced by arterial embolization. Chemoembolization and radioembolization are at the core of the treatment of liver hepatocellular carcinoma (HCC) patients who cannot receive potentially curative therapies such as transplantation, resection or percutaneous ablation. TACE for liver cancer has been proven to be useful in local tumor control, to prevent tumor progression, prolong patients' life and control patient symptoms...
April 2015: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Cristina Mosconi, Alberta Cappelli, Cinzia Pettinato, Rita Golfieri
Transarterial radioembolization (TARE) is a form of brachytherapy in which intra-arterially injected yttrium-90-loaded microspheres serve as a source for internal radiation purposes. On the average, it produces disease control rates exceeding 80% and it is a consolidated therapy for hepatocellular carcinoma (HCC); however, current data are all based on retrospective series or non-controlled prospective studies since randomized controlled trials comparing it with the other liver-directed therapies for intermediate and locally advanced stage HCC are still underway...
April 18, 2015: World Journal of Hepatology
Zeynep Gozde Ozkan, Arzu Poyanli, Adem Ucar, Serkan Kuyumcu, Filiz Akyuz, Serkan Keskin, Sezer Saglam, Ebru Yilmaz, Cetin Karaca, Cuneyt Turkmen
PURPOSE: Although some algorithms are defined for the treatment of advanced hepatocellular carcinoma (HCC), the expected survival cannot be prolonged as it is intended. Treatment options for this group of patients are limited. Radioembolization with yttrium-90 (Y-90) microspheres is a new treatment modality, which has also been used in advanced HCC patients. In this study, the authors aimed to assess the efficiency of radioembolization with Y-90 microspheres and evaluate prognostic factors that influence the survival in HCC patients...
April 2015: Cancer Biotherapy & Radiopharmaceuticals
Wataru Goto, Sadatoshi Shimizu, Masaya Kotsuka, Masayuki Sakae, Akishige Kanazawa, Tadashi Tsukamoto, Yoshito Yamashita, Yukio Nishiguchi
The first case involved a 38-year-old man who received a pancreaticoduodenectomy and hepatectomy for a pancreatic neuroendocrine tumor (pNET) with multiple liver metastases. A recurrent tumor was detected in his liver 3 months after surgery. The second case involved a 61-year-old woman who received a distal pancreatectomy for a pNET. Multiple liver metastases were detected 29 months later. Both patients received a combined therapy consisting of trans-catheter arterial chemoembolization (TACE) with degradable starch microspheres (DSM) and octreotide...
November 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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