Liver-directed treatments of liver-dominant metastatic leiomyosarcoma
PURPOSEThe purpose of this study was to determine the safety and efficacy of liver-directed therapies in patients with unresectable metastatic leiomyosarcoma to the liver. Liver-directed therapies included in this study were transarterial chemoembolization with doxorubicin eluting beads (DEB-TACE),...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2020-09-01
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| Series: | Diagnostic and Interventional Radiology |
| Online Access: |
http://www.dirjournal.org/archives/archive-detail/article-preview/liver-directed-treatments-of-liver-dominant-metast/54699
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| _version_ | 1797691320847826944 |
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| author | Hailey Krzyston Brian Morse Danielle Deperalta Anupam Rishi Roger Kayaleh Ghassan El-Haddad Johnna Smith Mihaela Druta Bela Kis |
| author_facet | Hailey Krzyston Brian Morse Danielle Deperalta Anupam Rishi Roger Kayaleh Ghassan El-Haddad Johnna Smith Mihaela Druta Bela Kis |
| author_sort | Hailey Krzyston |
| collection | DOAJ |
| description | PURPOSEThe purpose of this study was to determine the safety and efficacy of liver-directed therapies in patients with unresectable metastatic leiomyosarcoma to the liver. Liver-directed therapies included in this study were transarterial chemoembolization with doxorubicin eluting beads (DEB-TACE), yttrium-90 (Y90) radioembolization, and percutaneous microwave ablation.METHODSThis is a single institution retrospective study of unresectable metastatic leiomyosarcoma to the liver treated with DEB-TACE, radioembolization, or microwave ablation. DEB-TACE was performed using 70–150 or 100–300 µ doxorubicin-loaded drug-eluting LC beads. Radioembolization was performed using Y90 glass microspheres. Electronic medical records were retrospectively reviewed to evaluate clinical and biochemical toxicities, tumor response on imaging, overall survival (OS), and liver progression-free survival (PFS).RESULTSA total of 24 patients with metastatic leiomyosarcoma to the liver who underwent liver-directed treatment were identified (8 males, 16 females; average age, 62.8±11.4 years). Of these patients, 13 underwent DEB-TACE, 6 underwent Y90, and 5 underwent ablation. Three patients received a combination of treatments: one received Y90 followed by DEB-TACE, one received ablation followed by DEB-TACE, and one received ablation followed by Y90. Of the 24 patients, 19 received prior chemotherapy. At 3-month follow-up, grade 1 or 2 lab toxicities were found in 20 patients; 3 patients had grade 3 toxicities. A grade 3 clinical toxicity was reported in one patient. MELD score was 7.5±1.89 at baseline and 8.8±4.2 at 3 months. Median OS was 59 months (95% CI, 39.8–78.2) from diagnosis, 27 months (95% CI, 22.9–31.0) from development of liver metastasis, and 9 months (95% CI, 0–21.4) from first liver-directed treatment. Median liver PFS was 9 months (95% CI, 1.4–16.6).CONCLUSIONTreatment with liver-directed therapies for patients with unresectable metastatic leiomyosarcoma to the liver is safe and can improve overall survival, with OS after liver-directed therapy being similar to patients who underwent surgical resection. |
| first_indexed | 2024-03-12T02:12:43Z |
| format | Article |
| id | doaj.art-f996892dd7a542779f020132c6efece8 |
| institution | Directory Open Access Journal |
| issn | 1305-3825 1305-3612 |
| language | English |
| last_indexed | 2024-03-12T02:12:43Z |
| publishDate | 2020-09-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Diagnostic and Interventional Radiology |
| spelling | doaj.art-f996892dd7a542779f020132c6efece82023-09-06T13:00:25ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122020-09-0126544945510.5152/dir.2020.1940513049054Liver-directed treatments of liver-dominant metastatic leiomyosarcomaHailey Krzyston0Brian Morse1Danielle Deperalta2Anupam Rishi3Roger Kayaleh4Ghassan El-Haddad5Johnna Smith6Mihaela Druta7Bela Kis8 Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida, USA Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida, USA Department of Sarcoma Oncology, Moffitt Cancer Center, Tampa, Florida, USA Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida, USA Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida, USA Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida, USA Department of Sarcoma Oncology, Moffitt Cancer Center, Tampa, Florida, USA Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida, USA PURPOSEThe purpose of this study was to determine the safety and efficacy of liver-directed therapies in patients with unresectable metastatic leiomyosarcoma to the liver. Liver-directed therapies included in this study were transarterial chemoembolization with doxorubicin eluting beads (DEB-TACE), yttrium-90 (Y90) radioembolization, and percutaneous microwave ablation.METHODSThis is a single institution retrospective study of unresectable metastatic leiomyosarcoma to the liver treated with DEB-TACE, radioembolization, or microwave ablation. DEB-TACE was performed using 70–150 or 100–300 µ doxorubicin-loaded drug-eluting LC beads. Radioembolization was performed using Y90 glass microspheres. Electronic medical records were retrospectively reviewed to evaluate clinical and biochemical toxicities, tumor response on imaging, overall survival (OS), and liver progression-free survival (PFS).RESULTSA total of 24 patients with metastatic leiomyosarcoma to the liver who underwent liver-directed treatment were identified (8 males, 16 females; average age, 62.8±11.4 years). Of these patients, 13 underwent DEB-TACE, 6 underwent Y90, and 5 underwent ablation. Three patients received a combination of treatments: one received Y90 followed by DEB-TACE, one received ablation followed by DEB-TACE, and one received ablation followed by Y90. Of the 24 patients, 19 received prior chemotherapy. At 3-month follow-up, grade 1 or 2 lab toxicities were found in 20 patients; 3 patients had grade 3 toxicities. A grade 3 clinical toxicity was reported in one patient. MELD score was 7.5±1.89 at baseline and 8.8±4.2 at 3 months. Median OS was 59 months (95% CI, 39.8–78.2) from diagnosis, 27 months (95% CI, 22.9–31.0) from development of liver metastasis, and 9 months (95% CI, 0–21.4) from first liver-directed treatment. Median liver PFS was 9 months (95% CI, 1.4–16.6).CONCLUSIONTreatment with liver-directed therapies for patients with unresectable metastatic leiomyosarcoma to the liver is safe and can improve overall survival, with OS after liver-directed therapy being similar to patients who underwent surgical resection. http://www.dirjournal.org/archives/archive-detail/article-preview/liver-directed-treatments-of-liver-dominant-metast/54699 |
| spellingShingle | Hailey Krzyston Brian Morse Danielle Deperalta Anupam Rishi Roger Kayaleh Ghassan El-Haddad Johnna Smith Mihaela Druta Bela Kis Liver-directed treatments of liver-dominant metastatic leiomyosarcoma Diagnostic and Interventional Radiology |
| title | Liver-directed treatments of liver-dominant metastatic leiomyosarcoma |
| title_full | Liver-directed treatments of liver-dominant metastatic leiomyosarcoma |
| title_fullStr | Liver-directed treatments of liver-dominant metastatic leiomyosarcoma |
| title_full_unstemmed | Liver-directed treatments of liver-dominant metastatic leiomyosarcoma |
| title_short | Liver-directed treatments of liver-dominant metastatic leiomyosarcoma |
| title_sort | liver directed treatments of liver dominant metastatic leiomyosarcoma |
| url |
http://www.dirjournal.org/archives/archive-detail/article-preview/liver-directed-treatments-of-liver-dominant-metast/54699
|
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