Using Epirubicin-loaded DC Beads® for Superselective Embolisation of Liver Tumours – Initial Experiences
Using Epirubicin-loaded DC Beads® for Superselective Embolisation of Liver Tumours – Initial Experiences
Between July 2005 and December 2007 we treated a total of 66 patients with epirubicin-loaded drug-eluting beads. The majority of patients (83%) suffered from HCC (singular, multifocal or diffuse HCC), and the remaining from metastases (neuroendocrine tumour, cholangiocellular carcinoma, melanoma). Most of the patients received between one and three treatment cycles; however, some patients received more than three cycles. The standard dose given was 50mg epirubicin per 2ml vial of DC Beads. Sometimes, a double-dose strategy with up to 100mg of epirubicin was pursued, especially in patients suffering from secondary liver tumours or HCC with large feeding vessels that were easy to catheterise.
Figure 1e: After Applying 4ml DC Beads Loaded with 100mg of Epirubicin, Most of the Lesions Are Not Visible
Figure 1f: A Control Computed Tomography Scan 24 Hours After Embolisation Shows the Nearly Complete Embolisation of the Tumour at this Level
Figure 2a: T1-weighted Dynamic Liver Magnetic Resonance Scan
Scan shows a hypervascular liver lesion in the right lower lobe that was confirmed to be a well circumscribed hepatocellular carcinoma.
Scan shows a hypervascular liver lesion in the right lower lobe that was confirmed to be a well circumscribed hepatocellular carcinoma.
References:
- Livraghi T, Radiofrequency ablation, PEIT, and TACE for hepatocellular carcinoma, J Hepatobiliary Pancreat Surg, 2003;10:67–76.
- Vogl TJ, Mack MG, Straub R, et al., Interventionelle MR-gesteuerte laserinduzierte Thermotherapie bei onkologischen Fragestellunge, Radiologe, 1999;39:764–71.
- Llovet JM, Real MI, Montaña X, et al., Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial, Lancet, 2002;359:1734–9.
- Lo CM, Ngan H, TSO WK, et al., Randomised controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma, Hepatology, 2002;35:1164–71.
- Camma C, Schepis F, Orlando A, et al., Transarterial CHemoembolization for Unresectable Hepatocellular CArcinoma: Meta-Analysis of Randomized Controlled Trials, Radiology, 2002;224:47–54.
- Clark HP, Carson WF, Kavanagh PV, et al., Staging and Current Treatment of Hepatocellular Carcinoma, Radiographics, 2005;25:S3–23.
- Konno T, Targeting cancer chemotherapeutic agents by use of lipiodol contrast medium, Cancer, 1990;66:1897–1903.
- Egawa H, Maki A, Mori K, et al., Effects of intra-arterial chemotherapy with a new lipophilic anticancer agent, estradiol-chlorambucil, dissolved in lipiodol on experimental liver tumor in rats, J Surg Oncol, 1990;44:109–14.
- Nakamura H, Hashimoto T, Oi H, Sawada S, Transcatheter oily chemoembolization of hepatocellular carcinoma, Radiology, 1989;170:783–6.
- Sasaki Y, Imaoka S, Fujita M, et al., Regional Therapy in the Management of Intrahepatic Recurrence after Surgery for Hepatoma, Ann Surg, 1987;206:41–7.
- Lewis AL, Gonzalez MV, Lloyd AW, et al., DC bead: in vitro characterization of a drug-delivery decive for transarterial chemoembolization, J Vasc Interv Radiol, 2006;17:335–42.
- Fiorentini G, Aliberti C, Turrisi G, et al., Intra-arterial hepatic chemoembolization of liver metastases from colorectal cancer adopting irinotecan-eluting beads : results of a phase II clinical study, In Vivo, 2007;21:1085–91.
- Varela M, Real MI, Burrel M, et al., Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics, J Hepatol, 2007;46:474–81.
- Malagari K, Alexopoulou E, Chatzimichail K, et al., Transcatheter chemoembolization in the treatment of HCC in patients not eligible for curative treatments: mid-term results of doxorubicin-loaded DC bead, Abdom Imaging, 2007; Epub ahead of print.
- Poon RTP, Tso WK, Pang RWC, et al., A Phase I/II Trial of Chemoembolization for Hepatocellular Carcinoma Using a Novel Intra-arterial Drug-Eluting Bead, Clin Gastroenterol Hepatol, 2007;5:1100–1108.
