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Stambo et al. LC Bead embolization of hepatic neoplasms

Figure 5: Three months follow-up positron emission tomography scans demonstrating no uptake within the tumor consistent with complete
tumor kill

enhancing variable sized tumor masses more common results with irinotecan eluting beads for the first 12
in the right hepatic lobe compared to the left. As in the colorectal metastasis patients, it was clear that this
case presented, 2 of the HCC patients had tumors treatment protocol was not effective and needed to be
greater than 10 cm in diameter. Most were single replaced for the benefit of our patients. Certainly, the
lesions without regional adenopathy or metastasis. results were surprising to our researchers especially
Two of the patients had multiple liver masses at time according to the results documented in the medical
of treatment. The TNM staging for the HCC patients oncology literature related to irinotecan treatment
in this study ranged from primary tumor T1, T2 and of colorectal metastasis. The medical oncologists
T3a. There were no primary tumors T3b or T4 lesions. reviewed all cases with the interventional radiologists
There were no regional lymph nodes N0 and no distant and together agreed to replace the protocol in response
metastasis M0. to the poor irinotecan results. Furthermore, from the
onset of the study, all of the HCC patients received
In total, 36/48 (75%) of the patients received doxorubicin doxorubicin based on the chemotherapy data results
and 12/48 (25%) patients received irinotecan. The at that time.
majority (52%) of patients had colon metastasis. Of
those, 13/25 (52%) received doxorubicin and 12/25 Frequencies and percentages were used to
(48%) received irinotecan. Thirteen patients (27%) characterize demographic, clinical, and outcomes
had HCC and all 13 received doxorubicin. Of the 10 data from our consecutive case series. Two outcome
remaining tumor types, all received doxorubicin. Due categories were created for patients with colorectal
to changes in practice over the course of the year when metastasis by combining those with partial response
patients were treated, the first 12 colon metastasis or stable disease into one category and those with
patients out of the 25 received irinotecan and all worsened disease into a second category. Due to the
the remaining colon metastasis patients received small sample size, a Fisher’s exact test was used to
doxorubicin. Initially, the colon metastasis patients test the hypothesis that among those with colorectal
received irinotecan based on the chemotherapy data metastases, outcomes (i.e. partial response or stable
at that time. However, the initial results of the first 12 disease vs. worsened disease) differed according
patients were statistically poor and the investigators to the type of treatment received (doxorubicin vs.
replaced irinotecan with doxorubicin on all the irinotecan). The difference was considered statistically
remaining patients in the study. Based on the poor significant at an alpha of 0.05.
144 Hepatoma Research ¦ Volume 3 ¦ July 12, 2017