Liver embolizations in oncology: A review: Part I. Arterial (chemo)embolizations

Magnetic Nanomaterials for Arterial Embolization and Hyperthermia of Parenchymal Organs Tumors: A Review

Magnetic hyperthermia (MH), proposed by R. K. Gilchrist in the middle of the last century as local hyperthermia, has nowadays become a recognized method for minimally invasive treatment of oncological diseases in combination with chemotherapy (ChT) and radiotherapy (RT). One type of MH is arterial embolization hyperthermia (AEH), intended for the presurgical treatment of primary inoperable and metastasized solid tumors of parenchymal organs. This method is based on hyperthermia after transcatheter arterial embolization of the tumor’s vascular system with a mixture of magnetic particles and embolic agents. An important advantage of AEH lies in the double effect of embolotherapy, which blocks blood flow in the tumor, and MH, which eradicates cancer cells. Consequently, only the tumor undergoes thermal destruction. This review introduces the progress in the development of polymeric magnetic materials for application in AEH.

Clinical trial of cisplatin-conjugated gelatin microspheres for patients with hepatocellular carcinoma

PURPOSE

We report our initial experience with the transarterial chemoembolization (TACE) of unresectable hepatocellular carcinoma (HCC) using cisplatin-conjugated gelatin microspheres (Cis-GMS).

METHODS AND MATERIAL

Nineteen patients with 25 HCC nodules (mean diameter 23.0 mm) were treated by selective TACE using 50- to 100-μm Cis-GMS. Tumor necrosis and postembolization syndrome were assessed during the follow-up. The tumor response was evaluated on contrast-enhanced computed tomography images at 1 and 3 months after TACE using Cis-GMS.

RESULTS

All procedures were technically successful in all patients; following the TACE using Cis-GMS, there were no major complications, and postembolization syndrome was minimal. At the 1-month follow-up, the response rate was 12 of the 25 (48%) and 21 of the 25 (84%) HCC nodules based on RECIST 1.1 and EASL criteria, respectively; at the 3-month follow-up, it was 10 of the 25 (40%) and 14 of the 25 (56%) HCC nodules, respectively.

CONCLUSION

Our initial experience with using Cis-GMS for TACE suggests that these drugs may represent an optimal treatment option for the treatment of advanced HCC and that the use of gelatin microspheres loaded with chemotherapeutic agents warrants further study.

Embolization as an alternative treatment of insulinoma in a patient with multiple endocrine neoplasia type 1 syndrome

Insulinoma is a rare neuroendocrine tumor, most commonly originating from the pancreas, which is either sporadic or familial as a component of multiple endocrine neoplasia type 1 syndrome (MEN1). It is characterized by increased insulin secretion leading to hypoglycemia. Surgical removal is considered the treatment of choice, with limited side effects and relatively low morbidity and mortality, both being improved by the laparoscopic procedure. We present the case of a 30-year-old patient with MEN1 and recurrent insulinoma with severe hypoglycemic episodes who could not be surgically treated due to the adherence of the tumor to large blood vessels and to prior multiple surgical operations. He was treated by repeated embolization using spherical polyvinyl alcohol particles, resulting in shrinkage of the tumor, improvement of the frequency and severity of the hypoglycemic episodes, and better quality of life.