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Stambo et al. LC Bead embolization of hepatic neoplasms

Table 1: Summary of liver neoplasms and treatment type (n = 48)
Treatment type, n (%)
Type of neoplasm Number of patients Number deceased
Doxorubicin Irinotecan
Colorectal metastases 25 13 (52) 12 (48) 1
Primary hepatoma (HCC) 13 13 (100) 0 1
Breast metastases 3 3 (100) 0
Lung metastases 1 1 (100) 0
Melanoma metastases 1 1 (100) 0
Sarcoma metastases 1 1 (100) 0
Pancreatic metastases 1 1 (100) 0
Neuroendocrine metastases 1 1 (100) 0
Adrenal metastases 1 1 (100) 0
Pediatric hepatoblastoma 1 1 (100) 0 1
HCC: hepatocellular carcinoma
Table 2: Treatment responses for patients according to tumor and treatment types
Tumor and treatment types Complete response Partial response Worsened No follow-up
Hepatocellular carcinoma
Doxorubicin (n = 13) 8 1 2* 2
Colon metastases
Doxorubicin (n = 13) 6 4 1 2
Irinotecan (n = 12) 0 1 10* 1
*1 patient died

Table 3: Two-by-two contingency table used to test the whom follow-up data were available, those 11 who
hypothesis that among those with colon metastases, were treated with doxorubicin were significantly more
those treated with irinotecan had worse outcomes than likely to demonstrate complete or partial response
those treated with doxorubicin
compared to the 11 in the irinotecan treated group (P
Complete or < 0.001) [Table 3].
partial response Worsened
Doxorubicin treated (n = 11) 10 1
Irinotecan treated (n = 11) 1 10 DISCUSSION
RESULTS Our study compared how HCC and colorectal
metastases responded to catheter directed LC Bead
A total of 48 patients with unresectable malignant emobolization with irinotecan and doxorubicin. The
neoplasms of the liver were treated in a 1-year period. results were compelling for a small sample size. Of
There were 28 men (age ranging 34-88 years, with a the 13 colon cancer study patients who were treated
mean age of 60.5 years) and 20 women (age ranging with doxorubicin, 46.2% had a complete response and
34-92 years, with a mean age of 66.2 years). Six 4/13 (30.8%) had stable disease. The HCC patients
patients were lost to follow-up at time of this article. The on the other hand improved significantly with 81%
series includes HCC and colon metastasis [Figure 1]. demonstrating complete or partial response and 91%
All of the HCC tumors were hyper-vascular on of them alive at 24 months after treatment.
angiography and became hypo-vascular on follow
up scans [Figures 2, 3 and 5]. Many of the remaining Overall, the results of this study demonstrated that
tumor types demonstrated hypo-vascular appearance many patients with unresectable colon metastasis or
on angiography as compared to HCC. The tumor and HCC who were treated with doxorubicin drug eluting
treatment types are outlined in Table 1. beads demonstrated a complete or partial response. All
of these patients treated with doxorubicin who showed
Table 2 shows treatment responses according to complete or partial response remained in remission
tumor and treatment types. Nine of the 11 (81.8%) from liver disease for at least 24 months. However,
doxorubicin treated HCC patients had either complete those colon metastasis patients treated with irinotecan
response or partial response. All of the HCC lesions eluting beads did poorly and the study investigators
showed reduction in size and tumor enhancement and stopped using irinotecan on the remaining patient
10/11 (91%) HCC patients were alive at 24 months cohort. Only 1 patient out of 12 (8.3%) demonstrated
post treatment [Table 2]. Fisher’s exact test revealed partial response with irintoecan. Even those patients
that among the 22 with colorectal metastases for who responded to systemic irinotecan therapy prior
Hepatoma Research ¦ Volume 3 ¦ July 12, 2017 145