CC BY-NC-ND 4.0 · South Asian J Cancer 2019; 08(01): 31-34
DOI: 10.4103/sajc.sajc_205_17
ORIGINAL ARTICLE: GI Cancers

Transarterial radioembolization with Iodine-131-Lipiodol for hepatic metastases from gastrointestinal malignancies – Experience in tertiary care oncology center in India

Vidya Bhargavi
Department of Interventional Radiology, Health Care Global Hospitals, Bengaluru, Karnataka
,
Indusekhar Subbanna
Department of Interventional Radiology, Health Care Global Hospitals, Bengaluru, Karnataka
,
K. G. Kallur
Department of Nuclear Medicine, Health Care Global Hospitals, Bengaluru, Karnataka
,
Aakash Patel
Department of Radiology, Shalby Hospitals, Ahmedabad, Gujarat
,
Shivakumar Swamy
Department of Interventional Radiology, Health Care Global Hospitals, Bengaluru, Karnataka
,
Shekar Patil
Department of Medical Oncology, Health Care Global Hospitals, Bengaluru, Karnataka
› Author Affiliations
Financial support and sponsorship: Nil.

Abstract

Context: Unresectable colorectal hepatic metastases can be treated with radioembolization. Aims: The aim of this study is to analyze the response and survival benefits of transarterial radioembolization (TARE) with Iodine-131 (131I) Lipiodol for hepatic metastases from gastrointestinal malignancies. Settings and Design: Retrospective study of 20 patients with pathologically proven hepatic metastases from primary gastrointestinal malignancies referred for palliative therapy with TARE. Subjects and Methods: At baseline, standard laboratory and imaging data were recorded. All patients fulfilling the inclusion/exclusion criteria underwent TARE with 131I Lipiodol. Post procedure, the patients were reviewed after 1 month with follow-up positron emission tomography–computed tomography and tumor marker levels to evaluate treatment response with continued follow-up till December 2016 and overall survival calculated. Statistical Analysis Used: Data were analyzed using a statistical analysis package (Social sciences, version 15.0 for Windows; SSPS Inc.). Survival data were plotted using Kaplan–Meier survival curves. Results: At the end of follow-up period, 15 of 20 patients were alive. The mean and median survival was 38.88 ± 5.0 months (95% confidence interval [CI], 29.03–48.74 months, P = 0.17) and 49.3 ± 12.4 months (95% CI, 25.0–73.7 months, P = 0.17), respectively. 66 months survival was 75%. Response evaluation in 10 patients showed partial response in 3 (30%), stable disease in 2 (20%) and progressive disease in 5 (50%) patients. All patients with partial response showed a reduction in serum tumor marker levels. Conclusions: TARE with 131I-Lipiodol is highly effective with a significant survival benefit in refractory cases of hepatic metastases from gastrointestinal malignancies.



Publication History

Article published online:
21 December 2020

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  • References

  • 1 Namasivayam S, Martin DR, Saini S. Imaging of liver metastases: MRI. Cancer Imaging 2007;7:2-9.
  • 2 Sasson AR, Sigurdson ER. Surgical treatment of liver metastases. Semin Oncol 2002;29:107-18.
  • 3 Ahmadzadehfar H, Sabet A, Biersack HJ, Risse J. Therapy of hepatocellular carcinoma with iodine-131-lipidiol. In: Lau JW, editor. Hepatocellular Carcinoma – Clinical Research. InTech; 2012.
  • 4 Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the barcelona-2000 EASL conference. European association for the study of the liver. J Hepatol 2001;35:421-30.
  • 5 Adam A. Interventional radiology in the treatment of hepatic metastases. Cancer Treat Rev 2002;28:93-9.
  • 6 Doherty GM, Way LW. Current Surgical Diagnosis & Treatment. McGraw-Hill Medical; 2006.
  • 7 Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1998. CA Cancer J Clin 1998;48:6-29.
  • 8 Oxley EM, Ellis H. Prognosis of carcinoma of the large bowel in the presence of liver metastases. Br J Surg 1969;56:149-52.
  • 9 Mulcahy MF, Lewandowski RJ, Ibrahim SM, Sato KT, Ryu RK, Atassi B, et al. Radioembolization of colorectal hepatic metastases using yttrium-90 microspheres. Cancer 2009;115:1849-58.
  • 10 Cosimelli M, Golfieri R, Cagol PP, Carpanese L, Sciuto R, Maini CL, et al. Multi-centre phase II clinical trial of yttrium-90 resin microspheres alone in unresectable, chemotherapy refractory colorectal liver metastases. Br J Cancer 2010;103:324-31.
  • 11 Murthy R, Xiong H, Nunez R, Cohen AC, Barron B, Szklaruk J, et al. Yttrium 90 resin microspheres for the treatment of unresectable colorectal hepatic metastases after failure of multiple chemotherapy regimens: Preliminary results. J Vasc Interv Radiol 2005;16:937-45.