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25 april 2017: lees ook dit artikel:

https://kanker-actueel.nl/NL/rfa-naast-systemische-chemo-geeft-betere-overall-overleving-359-procent-versus-89-procent-op-8-jaars-meting-voor-in-lever-uitgezaaide-darmkanker.html

29 mei 2012: Bron: Anticancer Res. 2011 Dec;31(12):4581-7

Trans Arteriële Chemo Embolisatie - TACE met zogeheten 'drug-eluting beads' levert langere ziektevrije tijd en betere kwaliteit van leven op voor patiënten met in de lever uitgezaaide darmkanker. Dit blijkt uit een Italiaanse studie met 108 patiënten met vergevorderde darmkanker stadium III en IV.

De drug-eluting beads is een techniek waarbij via een injectie of katheder met chemo geimpregneerde bolletjes worden ingebracht die kleine hoeveelheden chemo blijven afgeven gedurende een bepaalde periode. Deze methode lijkt op inwendige bestraling maar dan met chemo.

Foto: Scan van een patient voor en na de TACE met de verpakte chemo

En hier de grafiek van de ziektevrije tijd:

Het volledige studierapport: Trans-Arterial Chemoembolization of Metastatic Colorectal Carcinoma to the Liver Adopting DC Bead®, Drug-eluting Bead Loaded with Irinotecan: Results of a Phase II Clinical Study is gratis in te zien.

Deze animatie laat zien hoe de methode werkt.

In dit filmpje kunt u zien hoe de bolletjes worden klaargemaakt voor gebruik en hoe deze worden ingebracht. Bij primaire leverkanker wordt deze techniek al heel lang gebruikt. Bij andere vormen van kanker waaronder uitgezaaide darmkanker en longkanker wordt deze techniek ook onderzocht met vaak betere resultaten dan met systemische chemo of directe TACE - Trans Arteriële Chemo Embolisatie.

Heir het abstract van de studie. Als u hier klikt kunt u een volledig studie rapport gratis inzien van een tussen evaluatie van deze studie van vorig jaar. Inclusief referentielijst die ook onderaan dit artikel staat vermeld.

Het volledige studierapport van de meest recente presentatie kunt u hier tegen betaling inzien.

TACE with drug-eluting beads loaded with irinotecan could be proposed as palliative therapy for unresectable and chemotherapy resistant liver metastases from colectoral cancer

Anticancer Res. 2011 Dec;31(12):4581-7.

Trans-arterial chemoembolization of metastatic colorectal carcinoma to the liver adopting DC Bead®, drug-eluting bead loaded with irinotecan: results of a phase II clinical study.

Aliberti C, Fiorentini G, Muzzio PC, Pomerri F, Tilli M, Dallara S, Benea G.

Source

Unit of Oncological Interventional Radiology, IOV (IRCCS), Padova, Italy. camillo.aliberti@ioveneto.it

Abstract

Trans-arterial chemoembolization (TACE) is a promising locoregional therapy for the treatment of primary hepatic tumors and liver metastases. The aim of the study was to define the activity and outcome of using DC Bead, drug-eluting bead, a spherical embolic device capable of being loaded with irinotecan.

PATIENTS AND METHODS:

We conducted a double institutional, single arm, phase II clinical study to evaluate TACE adopting this device in 82 patients presenting with metastatic colorectal carcinoma to the liver after failing chemotherapy. The primary endpoints were tumor shrinkage, safety, feasibility, compliance, and overall survival. RECIST criteria were used to assess responses. Quality of life (QoL) was addressed using Edmonton SAS improvement scale.

RESULTS:

Out of 103 patients considered, 82 were enrolled and underwent a total of 185 treatments of TACE. The median number of TACE was 2.2 (1-4). A post-embolization syndrome was frequently observed. Adverse observed effects were: right upper quadrant pain (40%), fever (80%), nausea (27%) and increased transaminases (70%). The median follow-up was 29 months. Within one month after treatment, each patient received a computed tomograpic scan. It showed reduction of metastatic contrast enhancement in all patients. Responses were 78% at 3 months. After the first treatment, 75 out 82 patients declared an improvement of their well being lasting more than 18 weeks. The median duration of response was 6 (range 3-10) months; the median follow up was 29 (range 7-48) months. The median survival was 25 (range 6-34) months, with progression free survival at 8 (range 4-16) months.

CONCLUSION:

We suggest that TACE adopting DC Bead®, drug-eluting bead loaded with irinotecan could be proposed as palliative therapy for unresectable and chemotherapy resistant liver metastases from CRC.

PMID:: 22199334; [PubMed - indexed for MEDLINE]; References

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