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Lin JN, Su JH, Fu TY, Shih SL. Transarterial chemoembolization as a part of multi-modality treatment with drug-eluting beads for locally advanced breast cancer: A case report. Radiol Case Rep 2021; 16:3383-3388. [PMID: 34504630 PMCID: PMC8411206 DOI: 10.1016/j.radcr.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 11/28/2022] Open
Abstract
Locally advanced breast cancer (LABC) is generally treated with combined-modality therapy including systemic chemotherapy, surgery, radiotherapy, and targeted therapy due to its nature of rapid onset of metastatic disease and poor prognosis. In this case report, we present a 61-year-old female who suffered from a huge protruding breast mass (16.2cm) with superficial ulcerative wound noted for three months. LABC was diagnosed via core needle biopsy and PET-CT examination. Initially, she received combined systemic chemotherapy, hormone therapy and radiation therapy; however, severe necrosis caused rupture in part of the breast mass and extensive wound discharge resulting in difficulty in wound care and prolonged disease course. Trans-arterial chemoembolization with drug-eluting beads (DEB-TACE) was applied as a part of combined-modality therapy for shortening the time before surgery. HepaSphere (as one of the DEB) loaded with high dose of epirubicin (total 80mg) was infused intra-arterially due to the nature of slow-releasing effect and longer duration of ischemic effect. Shortly after DEB-TACE following in about 40 days, surgery was smoothly performed. Post-operative adjuvant target therapy and adjuvant chemotherapy with taxane were administered. There was no evidence of local recurrence or distal metastases after 9 months of follow-up. It is suggested that performing DEB-TACE prior to surgery becomes a part of multimodality treatment of LABC to achieve better local control, better wound care and shortened treatment course.
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Affiliation(s)
- Jau-Nan Lin
- Department of Radiology, Yuan's General Hospital, Taiwan
| | - Jung-Hui Su
- Department of Nurse Practitioner, Yuan's General Hospital, Taiwan
| | - Ting-Ying Fu
- Department of Pathology, Yuan's General Hospital, Taiwan
| | - Shen-Liang Shih
- Division of Breast Surgery, department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan
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Malagari K, Moschouris H, Kiakidis T, Harward S, Kelekis A, Vrakas S, Koundouras D, Filipiadis D, Glantzounis G, Emmanouil E, Chatziioannou A, Vergadis V, Elefsiniotis I, Koskinas J, Dourakis S, Kelekis N. Five-Years Outcome Analysis of 142 Consecutive Hepatocellular Carcinoma Patients Treated with Doxorubicin Eluting Microspheres 30-60 μm: Results from a Single-Centre Prospective Phase II Trial. Cardiovasc Intervent Radiol 2019; 42:1551-1562. [PMID: 31321482 DOI: 10.1007/s00270-019-02260-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/03/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess prospectively long-term results of doxorubicin-loaded HepaSphere 30-60 μm in consecutive patients with hepatocellular carcinoma (HCC) not amenable to curative treatments. PATIENTS AND METHODS Single-center study from June 2011 to December 2015 in 151 patients treated with 75 mg of doxorubicin per HepaSphere vial. Baseline: Barcelona Clinic Liver Cancer BCLC A/B was 49.3%/50.7%, and median diameter 6.1 cm (mean 6.7 ± 2.0). Liver function, local response (mRECIST), liver time to progression (LTTP), progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were recorded. RESULTS Final analysis included 142 patients with median follow-up of 46.8 months (range 4-72) without grade 4/5 AEs, and 30-day mortality was 0%. Mean number of scheduled treatments was 2.6 (range 1-3) and on demand 3 (range 1-8). Complete response for single tumor ≤ 5 cm was 75.0% and 66.7% for Child A and Child B, while for > 5 cm was 28.6% and 11.8%, respectively. OS was 31.0 months (mean 33.3 ± 15.2; range 8-69), notably for BCLC A 41 months (mean 41.1 ± 15.3; range 13-69) and for BCLC B 26.0 (mean 26.0 ± 10.5; range 8-51). OS at 1, 3 and 5 years: 95.8%, 75.7% and 21.4% for BCLC A, and 94.4%, 36.1% and 2.7% for BCLC B. Median LTTP for BCLC A was 11 months (mean 11.9 ± 4.7; range 3-24) and 7.5 for BCLC B (mean 7.9 ± 2.9). Local response was significant for OS and LTTP (p < 0.0001), while size and lesion number affected LPFS and OS (p < 0.001). CONCLUSIONS HepaSphere 30-60 μm loaded with doxorubicin provides a safe and effective treatment option for patients with HCC.
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Affiliation(s)
- K Malagari
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece. .,Attikon Hospital, Chaidari, Greece. .,Evgenidion Hospital, Athens, Greece.
| | - H Moschouris
- Radiology Department of Tzanion General Hospital, Athens, Greece
| | - Th Kiakidis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Evgenidion Hospital, Athens, Greece
| | - S Harward
- University of Massachusets Medical School, Worcester, MA, USA
| | - A Kelekis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece.,Evgenidion Hospital, Athens, Greece
| | - S Vrakas
- Tzanion Hospital, Athens, Greece
| | - D Koundouras
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - D Filipiadis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece
| | - G Glantzounis
- Department of Surgery, University Hospital of Ioannina (UOI), Ioannina, Greece
| | - E Emmanouil
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Evgenidion Hospital, Athens, Greece
| | - A Chatziioannou
- Evgenidion Hospital, Athens, Greece.,1st Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - V Vergadis
- Radiology Department of Laikon University Hospital, Athens, Greece
| | - I Elefsiniotis
- Department of Internal Medicine and Hepatology Unit, Agioi Anargyroi General and Oncology Hospital of Kifissia Hospital Timiou Stavrou and Noufaron, Kalyftaki, Athens, Greece
| | - J Koskinas
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - S Dourakis
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - N Kelekis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece.,Evgenidion Hospital, Athens, Greece
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Zurstrassen CE, Gireli LPDO, Tyng CJ, Bitencourt AGV, Guimarães MD, Barbosa PNV, Santos Cavalcante ACB, Matushita Junior JP, Amoedo MK, Coimbra FJ, Alves RCP, Chojniak R. Safety and efficacy of HepaSphere 50-100 μm in the treatment of hepatocellular carcinoma. MINIM INVASIV THER 2017. [PMID: 28635404 DOI: 10.1080/13645706.2017.1288142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
AIM To evaluate the effects of HepaSphere 50-100 μm (Merit Medical) as a doxorubicin carrier and embolization agent for the treatment of hepatocellular carcinoma (HCC). MATERIAL AND METHODS A prospective analysis of 18 patients recruited from a national cancer center was conducted. This analysis evaluated the efficacy and safety of HepaSphere, as expressed by the treatment response rate (measured by the modified Response Evaluation Criteria in Solid Tumors, mRECIST) and by the prevalence of treatment-related adverse events, respectively. RESULTS The cohort was predominantly male, with a mean age of 69 years. The objective response rate (complete + partial response) was 53.3%. The variable most likely to be associated with objective response was Barcelona Clinic Liver Cancer (BCLC) staging. The most prevalent adverse events were nausea, vomiting and abdominal pain. CONCLUSION HepaSphere chemoembolization yielded a substantial objective response rate with an acceptable toxicity profile and should be considered an option for HCC treatment.
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Affiliation(s)
| | | | - Chiang Jeng Tyng
- a Interventional Radiology Department , A.C. Camargo Cancer Center , São Paulo , Brazil
| | | | | | | | | | | | | | - Felipe Jose Coimbra
- c Abdominal Surgery Department , A.C. Camargo Cancer Center , São Paulo , Brazil
| | | | - Rubens Chojniak
- b Imaging Department , A.C. Camargo Cancer Center , São Paulo , Brazil
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