Efficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis
Abstract Background Systemic therapy is the standard treatment for unresectable colorectal cancer with liver metastasis (CRCLM). Transarterial chemoembolization with drug-eluting beads (DEB-TACE) is considered an effective treatment option for CRCLM. Few studies have investigated the combination of...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03253-w |
| _version_ | 1797414947493249024 |
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| author | Yen-Cheng Chen Ching-Wen Huang Ching-Chun Li Tsung-Kun Chang Wei-Chih Su Po-Jung Chen Yung-Sung Yeh Yu-Tang Chang Hsiang-Lin Tsai Ming-Chen Paul Shih Jaw-Yuan Wang |
| author_facet | Yen-Cheng Chen Ching-Wen Huang Ching-Chun Li Tsung-Kun Chang Wei-Chih Su Po-Jung Chen Yung-Sung Yeh Yu-Tang Chang Hsiang-Lin Tsai Ming-Chen Paul Shih Jaw-Yuan Wang |
| author_sort | Yen-Cheng Chen |
| collection | DOAJ |
| description | Abstract Background Systemic therapy is the standard treatment for unresectable colorectal cancer with liver metastasis (CRCLM). Transarterial chemoembolization with drug-eluting beads (DEB-TACE) is considered an effective treatment option for CRCLM. Few studies have investigated the combination of DEB-TACE, chemotherapy, and targeted therapy for CRCLM. In the present study, we evaluated the disease control rate (DCR), adverse events, and survival among patients with CRCLM who underwent the combination of DEB-TACE and chemotherapy/targeted therapy. Materials We retrospectively reviewed 35 patients with CRCLM who were treated between January 2015 and January 2021. Standard systemic chemotherapy, targeted therapy, and 66 DEB-TACE procedures were administered. Data were collected on each DEB-TACE procedure, including chemotherapy agents, tumor burden of liver metastasis, number of DEB-TACE courses, and adverse events. Patients who received DEB-TACE after failure of first-line systemic therapy were categorized into the first-line failure group. Patients who received DEB-TACE after the failure of second-line, third-line, or fourth-line therapy were categorized into the other group. Subgroup analysis was performed to compare overall survival (OS) and progression-free survival (PFS) between the two groups. Results In total, 35 patients with CRCLM (34 patients with adenocarcinoma and 1 patient with neuroendocrine carcinoma) were enrolled. In total, 13 patients (37.1%) had extrahepatic metastases at initial diagnosis. In this study, 66 DEB-TACE procedures were performed. The DCR was 54.3%. The median OS period was 47.4 months, and the estimated 3-year OS rate was 59.5%. The median PFS period was 6.3 months, and the estimated 1-year PFS rate was 20.6%. The PFS period was longer in the first-line failure group than in the other group (7.2 vs. 6.3 months). No significant difference was observed in OS between the two groups. Four episodes (6.1%) of grade 3 intra-abdominal infection were observed. Conclusion The combination of chemotherapy, targeted therapy, and DEB-TACE can lead to a favorable DCR and survival outcomes in patients with CRCLM. Early intervention with DEB-TACE (i.e., after the failure of first-line therapy) has the potential to extend the PFS period in patients with CRCLM. Severe adverse events were rare and manageable. Further prospective, randomized controlled studies are warranted to obtain more conclusive findings. |
| first_indexed | 2024-03-09T05:41:18Z |
| format | Article |
| id | doaj.art-8f8a694213d340359c249d54b9c10668 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-09T05:41:18Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-8f8a694213d340359c249d54b9c106682023-12-03T12:24:58ZengBMCWorld Journal of Surgical Oncology1477-78192023-12-0121111110.1186/s12957-023-03253-wEfficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasisYen-Cheng Chen0Ching-Wen Huang1Ching-Chun Li2Tsung-Kun Chang3Wei-Chih Su4Po-Jung Chen5Yung-Sung Yeh6Yu-Tang Chang7Hsiang-Lin Tsai8Ming-Chen Paul Shih9Jaw-Yuan Wang10Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical UniversityDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical UniversityGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical UniversityGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical UniversityDivision of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDepartment of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical UniversityDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDepartment of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical UniversityAbstract Background Systemic therapy is the standard treatment for unresectable colorectal cancer with liver metastasis (CRCLM). Transarterial chemoembolization with drug-eluting beads (DEB-TACE) is considered an effective treatment option for CRCLM. Few studies have investigated the combination of DEB-TACE, chemotherapy, and targeted therapy for CRCLM. In the present study, we evaluated the disease control rate (DCR), adverse events, and survival among patients with CRCLM who underwent the combination of DEB-TACE and chemotherapy/targeted therapy. Materials We retrospectively reviewed 35 patients with CRCLM who were treated between January 2015 and January 2021. Standard systemic chemotherapy, targeted therapy, and 66 DEB-TACE procedures were administered. Data were collected on each DEB-TACE procedure, including chemotherapy agents, tumor burden of liver metastasis, number of DEB-TACE courses, and adverse events. Patients who received DEB-TACE after failure of first-line systemic therapy were categorized into the first-line failure group. Patients who received DEB-TACE after the failure of second-line, third-line, or fourth-line therapy were categorized into the other group. Subgroup analysis was performed to compare overall survival (OS) and progression-free survival (PFS) between the two groups. Results In total, 35 patients with CRCLM (34 patients with adenocarcinoma and 1 patient with neuroendocrine carcinoma) were enrolled. In total, 13 patients (37.1%) had extrahepatic metastases at initial diagnosis. In this study, 66 DEB-TACE procedures were performed. The DCR was 54.3%. The median OS period was 47.4 months, and the estimated 3-year OS rate was 59.5%. The median PFS period was 6.3 months, and the estimated 1-year PFS rate was 20.6%. The PFS period was longer in the first-line failure group than in the other group (7.2 vs. 6.3 months). No significant difference was observed in OS between the two groups. Four episodes (6.1%) of grade 3 intra-abdominal infection were observed. Conclusion The combination of chemotherapy, targeted therapy, and DEB-TACE can lead to a favorable DCR and survival outcomes in patients with CRCLM. Early intervention with DEB-TACE (i.e., after the failure of first-line therapy) has the potential to extend the PFS period in patients with CRCLM. Severe adverse events were rare and manageable. Further prospective, randomized controlled studies are warranted to obtain more conclusive findings.https://doi.org/10.1186/s12957-023-03253-wColorectal cancer with liver metastasisDrug-eluting beadTrans-arterial chemoembolizationTargeted therapyChemotherapy |
| spellingShingle | Yen-Cheng Chen Ching-Wen Huang Ching-Chun Li Tsung-Kun Chang Wei-Chih Su Po-Jung Chen Yung-Sung Yeh Yu-Tang Chang Hsiang-Lin Tsai Ming-Chen Paul Shih Jaw-Yuan Wang Efficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis World Journal of Surgical Oncology Colorectal cancer with liver metastasis Drug-eluting bead Trans-arterial chemoembolization Targeted therapy Chemotherapy |
| title | Efficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis |
| title_full | Efficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis |
| title_fullStr | Efficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis |
| title_full_unstemmed | Efficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis |
| title_short | Efficacy of transarterial chemoembolization with drug-eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis |
| title_sort | efficacy of transarterial chemoembolization with drug eluting beads combined with systemic chemotherapy and targeted therapy in colorectal cancer liver metastasis |
| topic | Colorectal cancer with liver metastasis Drug-eluting bead Trans-arterial chemoembolization Targeted therapy Chemotherapy |
| url | https://doi.org/10.1186/s12957-023-03253-w |
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