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Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery

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Role of hepatic arterial chemoembolization in the treatment of elderly and geriatric patients with metastatic colorectal cancer

https://doi.org/10.16931/10.16931/1995-5464.2021-2-83-90

Abstract

AimTo improve the results of the treatment of colorectal cancer with hepatic metastases in patients over 60 years old by applying selective chemoembolization of the hepatic artery.

Materials and methods. At the Central Clinical Hospital “Railways-Medicine“, 20 patients over 60 years old with colorectal cancer liver metastases were treated. Ten patients in the control group received systemic chemotherapy. In the main group, 10 patients underwent chemoembolization of the hepatic artery using microspheres saturated with doxorubicin. Treatment results were assessed using the RECIST 1.1 scale. We considered the immediate and long- term results up to 12 months after the treatment.

ResultsA partial response according to the RECIST 1.1 scale was detected in 4 patients from the main group (40%), stabilization of the oncological process in the liver in 2 (20%) patients, progression of the metastatic process was detected in 4 (40%) patients. There were no deaths within 12 months after the chemotherapy. In the control group, stabilization was observed in 2 (20%) patients after systemic chemotherapy according to the RECIST 1.1 scale, and progression was diagnosed in 8 (80%) patients. One death (10%) was noted during the observation period.

Conclusion. The use of selective chemoembolization of the hepatic artery in the main group of patients has shown its effectiveness while preserving a satisfactory quality of life (QLP).

About the Authors

O. Y. Stukalova
Central Clinical Hospital “Railways-Medicine”; Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Oksana Y. Stukalova – Coloproctologist, Coloproctology (Oncology) Department; Postgraduate Student of the Department of Oncology and Radiology

2, Budayskaya str., 129128, Moscow

20/1, Delegatskaya str., 127473, Moscow



G. P. Guens
Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Gelena P. Guens – Doct. of Sci. (Med.), Professor, Head of the Oncology and Radiology Department

20/1, Delegatskaya str., 127473, Moscow



Z. H. Shugushev
JSC “Railways-Medicine”
Russian Federation

Zaurbek H. Shugushev – Doct. of Sci. (Med.), Professor, Chief Cardiologist

2, Budayskaya str., 129128, Moscow



References

1. Ionkin D.A., Zhavoronkova O.I., Stepanova Y.A., Gavrilov Y.Y., Vishnevsky V.A., Chzhao A.V. Termal methods of local destruction (RFA, cryodestruction, microwave ablation) in metastatic liver cancer. Aspirantskiy Vestnik Povolzhiya. 2018; 18 (5–6): 127–145. https://doi.org/10.17816/20722354.2018.18.3.127-145 (In Russian)

2. Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J., Jemal A. Global cancer statistics, 2012. CA. Cancer. J. Clin. 2015; 65 (2): 87–108. https://doi.org/10.12691/ajcp-5-1-2.

3. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2018. CA. Cancer. J. Clin. 2018; 68 (1): 7–30. https://doi.org/10.3322/caac.21442.

4. Sostoyanie onkologicheskoj pomoshhi naseleniyu Rossii v 2017 godu [The state of cancer care in Russia in 2017]. Edited by A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Moscow: Р.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation, 2018. P. 76–79. (In Russian)

5. Seregin A.A. Endovascular hepatic artery chemoembolization is an advanced technique of regional chemotherapy in malignant hepatic tumors (review). Sonremennye Tehnologii v Medicine = Modern Technologies in Medicine. 2014; 2: 110–126. (In Russian)

6. Venderbosch S., de Wilt J.H., Teerenstra S., Loosveld O.J., van Bochove A., Sinnige H.A., Creemers G.J., Tesselaar M.E., Mol L., Punt C.J., Koopman M. Prognostic value of resection of primary tumor in patients with stage IV colorectal cancer: retrospective anaysis of two randomized studies and a review of the literature. Ann. Surg. Oncol. 2011; 18 (12): 3252–3260. https://doi.org/10.1245/s10434-011-1951-5.

7. Chua T.C., Saxena A., Liauw W., Kokandi A., Morris D.L. Systematic review of randomized and nonrandomized trials of the clinical response and outcomes of neoadjuvant systemic chemotherapy for resectable colorectal liver metastases. Ann. Surg. Oncol. 2010; 17 (2): 492–501. https://doi.org/10.1245/s10434-009-0781-1.

8. Zagainov A.S., Shelekhov A.V., Dvornichenko V.V., Rasulov R.I., Zubkov R.A. Treatment outcomes of colorectal cancer with bilateral liver metastases. Siberian journal of oncology. 2017; 16 (1): 66–70. https://doi.org/10.21294/1814-4861-2017-16-1-66-70 (In Russian)

9. Abdulaev M.A., Napol’skaya E.V., Tsikoridze M.Yu. Minimally invasive methods of local treatment for colorectal cancer liver metastases: state-of-the art (a review of literature). Pelvic Surgery and Oncology. 2016; 6 (1): 43–46. https://doi.org/10.17650/22203478-2016-6-1-43-47 (In Russian)

10. Chernyadev A.S., Zasorin A.A., Maksimova K.I. The complicated colorectal cancer: analysis of a current state of problem. Ural Medical Journal. 2016; 7 (140): 156–160. (In Russian)

11. Zubritsky V.F., Levchuk A.L., Shasholin M.A. Khirurgicheskoe lechenie bol`ny`x oslozhnenny`mi formami raka tolstoj kishki [Surgical treatment of patients with complicated colon cancer]. Moscow: MOSCOW, 2019. 11 p. (In Russian)

12. Kolorektalnyj rak. Diagnostika i taktika lecheniya [Colorectal cancer. Diagnostics and treatment tactics]. Scholefield J., Eng C.; transl. Shely`gin Yu.A. Moscow: Practical medicine, 2019. P. 175–186. (In Russian)

13. Ades S. Adjuvant chemotherapy for colon cancer in the elderly: moving from evidence to practice. Oncology (Williston Park). 2009; 23 (2): 162–167. PMID: 19323297.

14. Skvortsova N.V., Pospelova T.I., Kovynev I.B., Nechunaeva I.N. Comparative analysis of comorbidity indices with multiple myeloma. Siberian Medical Journal (Irkutsk). 2018; 153 (2): 29–36. (In Russian)

15. Yancik R. Cancer burden in the aged: an epidemiologic and demographic overview. Cancer. 1997; 80 (7): 1273–1283. PMID: 9317180.

16. Abdulaev M.A., Napolskaia E.V., Tsikoridze M.Y., Topuzov E.E., Topuzov E.G. The use of minimally invasive techniques in the treatment of colorectal cancer metastases in the liver (review). Ural Medical Journal. 2016; 138 (5): 109–114. (In Russian)

17. Vogl T.J., Lahrsow M., Albrecht M.H., Hammerstingl R., Thompson Z.M., Gruber-Rouh T. Survival of patients with nonresectable, chemotherapy-resistant colorectal cancer liver metastases undergoing conventional lipiodol-based transarterial chemoembolization (cTACE) palliatively versus neoadjuvantly prior to percutaneous thermal ablation. Eur. J. Radiol. 2018; 102 (14): 138–145. https://doi.org/10.1016/j.ejrad.2018.03.015.

18. Fiorentini G., Sarti D., Nani R., Aliberti C., Fiorentini C., Guadagni S. Updates of colorectal cancer liver metastases therapy: review on DEBIRI. Hepat. Oncol. 2020; 7 (1): HEP16. https://doi.org/10.2217/hep-2019-0010.

19. Gruber-Rouh T., Marko C., Thalhammer A., Nour-Eldin N.E., Langenbach M., Beeres M., Naguib N.N., Zangos S., Vogl T.J. Current strategies in interventional oncology of colorectal liver metastases. Br. J. Radiol. 2016; 89 (1064): 20151060. https://doi.org/10.1259/bjr.20151060.

20. Levy J., Zuckerman J., Garfinkle R., Acuna S.A., Touchette J., Vanounou T., Pelletier J.S. Intra-arterial therapies for unresectable and chemorefractory colorectal cancer liver metastases: a systematic review and meta-analysis. HPB (Oxford). 2018; 20 (10): 905–915. https://doi.org/10.1016/j.hpb.2018.04.001.

21. Popov A.A., Nevolskikh A.A., Polyarush N.F., Kozupitsa G.S. Colorectal liver metastases after chemoembolization with microspheres: prognostic value of lesion features and choice of the objective response criteria. Diagnostic radiology and radiotherapy. 2018; 3: 75–84. https://doi.org/10.22328/20795343-2018-9-3-75-84 (In Russian)

22. Bester L., Meteling B., Boshell D., Saxena A., Morris D.L. Current role of transarterial chemoembolization and radioembolization in the treatment of metastatic colorectal cancer. Hepat. Oncol. 2014; 1 (2): 215–228. https://doi.org/10.2217/hep.13.21.

23. Liapi E., Geschwind J.F.H. Chemoembolization for primary and metastatic liver cancer. Cancer J. 2010; 16 (2): 156–162. https://doi.org/10.1097/PPO.0b013e3181d7e905.

24. Seregin A.A., Zaitsev A.I., Sharabrin Ye.G., Rykhtik P.I., Chichkanova A.S., Shkalova L.V., Zagainov V.Ye. Roentgenendovascular chemoembolization of hepatic artery in focal liver lesions. Ukrainian journal of surgery. 2013; 3 (22): 25–33. (In Russian)

25. Tellez C., Benson A.B. 3rd, Lyster M.T., Talamonti M., Shaw J., Braun M.A., Nemcek A.A. Jr, Vogelzang R.L. Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature. Cancer. 1998; 82 (7): 1250–1259. https://doi.org/10.1002/(sici)1097-0142(19980401)82:7<1250::aid-cncr7>3.0.co;2-j.

26. Geschwind J., Hong K., Georgiades C. Utility of transcatheter arterial chemoembolization for liver dominant colorectal metastatic adenocarcinoma in the salvage setting. Presented at: American Society of Clinical Oncology Gastrointestinal Cancers Symposium. San Francisco, CA, USA, January 2006. P. 26–28.

27. Albert M., Kiefer M.V., Sun W., Haller D., Fraker D.L., Tuite C.M., Stavropoulos S.W., Mondschein J.I., Soulen M.C. Chemoembolization of colorectal liver metastases with cisplatin, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol. Cancer. 2011; 117 (2): 343–352. https://doi.org/10.1002/cncr.25387.

28. Khanevich M.D., Kukanov M.A., Chalaev A.G., Dinikin M.S., Fadeev R.V., Zorina E.Y. Hepatic artery chemoembolization by drug-saturated embosphere in the treatment of patients with primary and metastatic liver tumours. Russian Journal of Oncology. 2014; 19 (4): 49–50. (In Russian)

29. Tsurkan V.A., Khairutdinov E.R., Arablinsky A.V. Results of the liver arterial chemoembolization in patients with metastatic colorectal cancer. International journal of interventional cardioangiology. 2017; 48–49: 94. (In Russian)

30. Brink J.A. Use of high concentration contrast media (HCCM): principles and rationale-body CT. Eur. J. Radiol. 2003; 45 (Suppl 1): S53–58. https://doi.org/10.1016/s0720-048x(02)00362-5.

31. Kurup A.N., Callstrom M.R. Ablation of musculoskeletal metastases: pain palliation, fracture risk reduction, and oligometastatic disease. Tech. Vasc. Interv. Radiol. 2013; 16 (4): 253–261. https://doi.org/10.1053/j.tvir.2013.08.007.

32. Seregin A.A., Zaytsev A.A., Zagaynov E.М., Sharabrin E.G., Zagaynov V.E. Endovascular chemotmbolization of the hepatic artery – a modern method of local chemotherapy of malignant liver lesions. Creative surgery and oncology. 2017; 7 (1): 57–62. https://doi.org/10.24060/2076-3093-2017-7-1-57-62 (In Russian)


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Stukalova O.Y., Guens G.P., Shugushev Z.H. Role of hepatic arterial chemoembolization in the treatment of elderly and geriatric patients with metastatic colorectal cancer. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(2):83-90. (In Russ.) https://doi.org/10.16931/10.16931/1995-5464.2021-2-83-90

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ISSN 1995-5464 (Print)
ISSN 2408-9524 (Online)