Drug-eluting microspheres transarterial chemoembolization (DEM TACE) in patients with liver metastases. Pilot study.

BACKGROUND: Only 10 to 20% of patients with hepatic metastases qualify for radical resection of their lesions. The treatment issue among the rest of patients is a small clinical response to overall chemiotherapy and the frequent inability to treat patients with percutaneous thermoablation. In the latter circumstance, parallel to the radical surgery, the reason is the size of the lesion or lack of access to it.

MATERIAL/METHODS: 15 patients with hepatic metastases, who had been rejected from consideration of radical resection and thermoablation were subjected to chemoembolization of the proper hepatic artery branches. The procedure was performed using Hepasphere 50-100 μm impregnated with 100 mg of Doxorubicine. The primary tumor sites included: colorectal ca, cholangiocarcinoma, gastrinoma, gallbladder ca, pancreatic ca, GIST, lung ca, kidney ca, breast ca and larynx ca. The evolution of the disease was monitored by MRI scanning, which was performed after a mean time of 7.6 weeks from the chemoembolization. During the study, we compared patients' quality of life (using Edmonton Evaluating System); length of hospital stay, chemoembolization side effects, and remission or progression of the disease by the RECIST 1.1 scale.

RESULTS: 26.7% of patients had remission of the metastatic disease, 33.4% experienced stable desease and 26,7% suffered lesion progression. Two patients did not report to the MRI examination. Chemoembolzation's side effects were small and the quality of patients' live improved. Effectiveness depended on the overal condition of the patient, and the stage of the primary disease.

CONCLUSIONS: Chemoembolization is a minimally invasive, safe and possibly effective palliative procedure in patients with hepatic metastases. Further investigation on a larger group of patients is required and will be continued.