X-ray-endovascular interventions in the treatment of patients with liver metastases of colorectal cancer after the termination of systemic chemotherapy

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Background: At present, the problem of treating common forms of colorectal cancer does not lose its relevance due to the increase in its incidence. Systemic chemotherapy is the main line of treatment for patients with unresectable liver metastases. However, a significant problem of modern oncology is the further treatment tactics for patients with chemoresistant metastases. Aims: to improve the treatment results for patients with chemoresistant liver metastases of colorectal cancer. Method: 36 patients with unresectable liver metastases of colorectal cancer were treated at the Granov Russian Research Center of Radiology and Surgical Technologies and the «RZD-Medicine» Central Clinical Hospital. For all the patients, systemic chemotherapy was considered unreasonable due to the development of chemoresistance or a high degree of toxicity. The patients underwent regional chemotherapy — chemoinfusion and/or chemoembolization of the hepatic artery. Results: The treatment evaluation was performed using the RECIST 1.1 scale. After 6 months, a partial response was reached in 1 patient (2.8%), stabilization was observed in 29 (80.5%) patients, and 6 patients (16.7%) had the disease progression. In 2 (5.6%) cases, a lethal outcome was observed against the background of the systemic progression of the oncological disease. One year later, stabilization of the malignant process was detected in 21 (58.3%) cases, progression was detected in 15 (41.7%) cases. A one-year survival of patients was 83.3%, the overall survival — 22 months. Conclusion: The use of interventional radiology methods has shown its effectiveness in patients with unresectable chemoresistant liver metastases of colorectal cancer.

About the authors

Oksana Yu. Stukalova

Central Clinical Hospital «RZD-Medicine»

Author for correspondence.
Email: docstukalova@mail.ru
ORCID iD: 0000-0003-3748-4750
Russian Federation, Moscow

Aleksey A. Polikarpov

Granov Russian Research Center of Radiology and Surgical Technologies

Email: pol1110@mail.ru
ORCID iD: 0000-0002-7683-5042

MD, PhD, Professor

Russian Federation, Saint Petersburg

Roman V. Ishchenko

Lomonosov Moscow State University

Email: Ischenkorv@rambler.ru
ORCID iD: 0000-0003-0260-6922

MD, PhD, Professor

Russian Federation, Moscow

Zaurbek Kh. Shugushev

Central Clinical Hospital «RZD-Medicine»; Peoples’ Friendship University of Russia

Email: zaur937@mail.ru
ORCID iD: 0000-0002-5335-5062

MD, PhD, Professor

Russian Federation, Moscow; Moscow

References

  1. Куликовский В.Ф., Олейник Н.В., Солошенко А.В., и др. Результаты хирургического лечения больных с метастазами колоректального рака в печени // Колопроктология. 2016. № S1. С. 65–66. [Kulikovsky VF, Oleinik NV, Soloshenko AV, et al. Results of surgical treatment of patients with metastases of colorectal cancer in the liver. Coloproctology. 2016;(S1): 65–66. (In Russ).]
  2. Состояние онкологической помощи населению России в 2018 году / под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. Москва, 2019. С. 76–79. [The state of oncological care to the population of Russia in 2018. Ed. By A.D. Kaprin, V.V. Starinsky, G.V. Petrovа. Moscow; 2019. Р. 76–79. (In Russ).]
  3. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30. doi: 10.3322/caac.21442
  4. Загайнов А.С., Шелехов А.В., Дворниченко В.В., и др. Результаты комплексного лечения колоректального рака с билатеральным метастатическим поражением печени // Сибирский онкологический журнал. 2017. Т. 16, № 1. С. 66–70. [Zagainov AS, Shelekhov AV, Dvornichenko VV, et al. Results of complex treatment of colorectal cancer with bilateral metastatic liver damage. Siberian Oncological Journal. 2017;16(1):66–70. (In Russ).]
  5. Rashidian N, Alseidi A, Kirks RC. Cancers metastatic to the liver. Surg Clin North Am. 2020;100(3):551–563. doi: 10.1016/j.suc.2020.02.005
  6. Adenis A, de la Fouchardiere C, Paule B, et al. Survival, safety, and prognostic factors for outcome with Regorafenib in patients with metastatic colorectal cancer refractory to standard therapies: results from a multicenter study (REBECCA) nested within a compassionate use program. BMC Cancer. 2016;16(7):412–420. doi: 10.1186/s12885-016-2440-9
  7. Трякин А.А., Артамонова Е.В., Болотина Л.В., и др. Практические рекомендации по лекарственному лечению рака прямой кишки // Злокачественные опухоли. 2016. № 4, S2. С. 266–285. [Tryakin AA, Artamonova EV, Bolotina LV, et al. Practical recommendations for the drug treatment of rectal cancer. Malignant tumors. 2016;(4 S2):266–285. (In Russ).]
  8. Переводчикова Н.И. Руководство по химиотерапии опухолевых заболеваний. 4-е изд. Москва: Практическая медицина, 2018. 512 с. [Perevodchikova NI. Guidelines for chemotherapy of tumor diseases. 4th ed. Moscow: Practical Medicine; 2018. 512 p. (In Russ).]
  9. Абдулаев М.А., Напольская Е.В., Цикоридзе М.Ю. Современное состояние проблемы малоинвазивных методов локального лечения метастазов колоректального рака в печени (обзор литературы) // Онкологическая колопроктология. 2016. № 6. С. 43–46. [Abdulaev MA, Napolskaya EV, Tsikoridze MYu. The current state of the problem of minimally invasive methods of local treatment of colorectal cancer metastases in the liver (literature review). Oncol Coloproctol. 2016;(6):43–47. (In Russ).] doi: 10.17650/2220-3478-2016-6-1-43-47
  10. Gruber-Rouh T, Naguib NN, Eichler K, et al. Transarterial chemoembolization of unresectable systemic chemotherapy-refractory liver metastases from colorectal cancer: Long-term results over a 10-year period. Int J Cancer. 2014;134:1225–1231. doi: 10.1002/ijc.28443
  11. Müller H, Nakchbandi V, Chatzisavvidis I, von Voigt C. Repetitive chemoembolization with melphalan plus intra-arterial immuno-chemotherapy within 5-fluorouracil and granulocyte-macrophage colony-stimulating factor (GM-CSF) as effective first- and second-line treatment of disseminated colorectal liver metastases. Hepatogastroenterology. 2003;50:1919–1926.
  12. Bhutiani N, Akinwande O, Martin RC. Efcacy and toxicity of hepatic intra-arterial drug-eluting (Irinotecan) bead (DEBIRI) therapy in irinotecan-refractory unresectable colorectal liver metastases. World J Surg. 2016;40(5):1178–1190. doi: 10.1007/s00268-015-3386-9
  13. Ren Y, Chen L, Huang S, et al. Transarterial chemoembolization of unresectable systemic chemotherapy refractory liver metastases: a retrospective single-center analysis. Abdom Radiol. 2020;45:2862–2870. doi: 10.1007/s00261-020-02584-6
  14. Поликарпов А.А., Таразов П.Г., Кагачева Т.И., и др. Метастазы колоректального рака в печени, не контролируемые системной химиотерапией: роль внутриартериальной химиотерапии // Анналы хирургической гепатологии. 2019. Т. 24, № 4. С. 37–44. [Polikarpov AA, Tarazov PG, Kagacheva TI, et al. Metastases of colorectal cancer in the liver, not controlled by systemic chemotherapy: the role of intra-arterial chemotherapy. Annals of Surgical Hepatology. 2019;24(4):37–44. (In Russ).] https://doi.org/10.16931/1995-5464.2019437-44

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2. Fig. 1. Regional treatment performance according to RECIST 1.1 criteria.

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Copyright (c) 2022 Stukalova O.Y., Polikarpov A.A., Ishchenko R.V., Shugushev Z.K.

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