Liver/biliary injuries following chemoembolisation of endocrine tumours and hepatocellular carcinoma: Lipiodol vs. drug-eluting beads

Guiu, Boris; Deschamps, Frédèric; Aho, Serge; Munck, Flore; Dromain, Clarisse; Boige, Valérie; Malka, David; Leboulleux, Sophie; Ducreux, Michel; Schlumberger, Martin; Baudin, Éric; Baère, Thierry De

doi:10.1016/j.jhep.2011.09.012

Cited by 169 publications

(123 citation statements)

References 32 publications

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“…PLA has been reported as a rare complication that occurs in less than 5% of TACE and 1% of the RFA. [8][9][10][11] Although the rate of this complication at our center was similar to the literature (4.1% in TACE and 1.2% in RFA), NBIPLA represented 15.5% of the overall population with first episodes of PLA. In our study, E. coli was the most frequently isolated agent, while K. pneumoniae resulted surprisingly scarce.…”

Section: Discussionsupporting

confidence: 83%

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Czerwonko

Huespe

Bertone

et al. 2016

HPB

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Section: Discussionsupporting

confidence: 83%

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Czerwonko

Huespe

Bertone

et al. 2016

HPB

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“…Unfortunately, no data were provided in this trial regarding serum levels of GGT and ALP. Interestingly, in our series, we did not observe portal vein narrowing, portal veinous thrombosis, or biloma/liver infarct after TACE, whereas such liver/biliary toxicities have been recently reported [17]. Therefore, the toxicity profile of idarubicin used for lipiodol TACE does not seem to be different from that observed with doxorubicin.…”

Section: Discussioncontrasting

confidence: 56%

“…Baseline imaging was performed \1 month before each TACE session, and follow-up imaging was performed within 6 weeks after each session. Liver/biliary toxicity (dilated bile duct, portal vein branch narrowing, portal venous thrombosis, and biloma/liver infarct) was assessed on follow-up imaging, according to previously published data [17]. Repeat TACE procedures were performed on the basis of tumor response and patient health.…”

Section: Follow-upmentioning

confidence: 99%

Lipiodol Trans-arterial Chemoembolization of Hepatocellular Carcinoma with Idarubicin: First Experience

Favelier

Boulin

Hamza

et al. 2012

Cardiovasc Intervent Radiol

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Background There is still no consensus about the best chemotherapeutic agent for transarterial chemoembolization (TACE). A recent in vitro study demonstrated that idarubicin, an anthracycline, was by far the most cytotoxic drug on human hepatocellular carcinoma (HCC) cell lines. Idarubicin is much more lipophilic than doxorubicin, leading to higher cell penetration through lipidic membranes and greater accumulation of the drug in the lipiodol. Furthermore, idarubicin has the ability to overcome multidrug resistance. Therefore, we designed this pilot human study to evaluate the safety and efficacy of lipiodol TACE using idarubicin. Methods In 21 consecutive patients treated by lipiodol TACE with idarubicin (10 mg) for HCC, safety data, tumor response (Response Evaluation Criteria in Solid Tumors, mRECIST), time to treatment failure (TTTF), and overall survival were evaluated. Results Postembolization syndrome was observed after 30.9 % (17 of 55) of sessions. No patient died from a TACE-related complication. No hematological grade 3-5 adverse event was observed. At least one grade 3 or higher adverse event occurred in 19 % (4 of 21) of patients. On imaging, no progression was encountered; four patients (24 %) exhibited stable disease, 12 (57 %) exhibited a partial response, and five (19 %) exhibited a complete response. Median TTTF was 16.7 months (Kaplan-Meier analysis). At 6 months, 94.7 % (95 % confidence interval [CI] 68.1-99.2) of patients did not reach treatment failure, whereas treatment failure was not reached in 50.6 % (95 % CI 21.6-73.9) of patients at 1 year. Overall survival was 83.5 % (95 % CI 57-94.4) at 1 year. Conclusion Idarubicin seems safe and effective in lipiodol TACE of HCC. This warrants further study to determine the potential of this drug to replace doxorubicin for TACE.

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“…After these two early reports, our institution reported a series of 120 patients with GEP-NET liver metastasis treated with either DEB-TACE or Lipiodol-TACE. In this patient cohort, the occurrence of liver/biliary injury in non-tumoral territories was strongly and independently associated with DEB-TACE (odds ratio (OR)Z6.63; P!0.001), and more serious complications such as bilomas and parenchymal infarcts were as well both significantly associated with DEB-TACE vs Lipiodol-TACE (ORZ9.78; PZ0.002) (48). Baghat et al (49) reported interim analysis of DEB-TACE in 13 patients with NET hepatic metastases as part of a phase II trial.…”

Section: Chemoembolization and Embolizationmentioning

confidence: 82%

GEP-NETS UPDATE: Interventional radiology: role in the treatment of liver metastases from GEP-NETs

Baère

Deschamps

Tselikas

et al. 2015

European Journal of Endocrinology

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Neuroendocrine tumors from gastro-pancreatic origin (GEP-NET) can be responsible for liver metastases. Such metastases can be the dominant part of the disease as well due to the tumor burden itself or the symptoms related to such liver metastases. Intra-arterial therapies are commonly used in liver only or liver-dominant disease and encompass trans-arterial chemoembolization (TACE), trans-arterial embolization (TAE), and radioembolization (RE). TACE performed with drug emulsified in Lipiodol has been used for the past 20 years with reported overall survival in the range of 3-4 years, with objective response up to 75%. Response to TACE is higher when treatment is used as a first-line therapy and degree of liver involvement is lower. Benefit of TACE over TAE is unproven in randomized study, but reported in retrospective studies namely in pancreatic NETs. RE provides early interesting results that need to be further evaluated in terms of benefit and toxicity. Radiofrequency ablation allows control of small size and numbered liver metastases, with low invasiveness. Ideal metastases to target are one metastasis !5 cm, or three metastases !3 cm, or a sum of diameter of all metastases below 8 cm. Ablation therapies can be applied in the lung or in the bones when needed, and more invasive surgery should be probably saved for large-size metastases. Even if the indication of image-guided therapy in the treatment of GEP-NET liver metastases needs to be refined, such therapies allow for manageable invasive set of treatments able to address oligometastatic patients in liver, lung, and bones. These treatments applied locally will save the benefit and the toxicity of systemic therapy for more advanced stage of the disease.

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Liver/biliary injuries following chemoembolisation of endocrine tumours and hepatocellular carcinoma: Lipiodol vs. drug-eluting beads

Cited by 169 publications

References 32 publications

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Lipiodol Trans-arterial Chemoembolization of Hepatocellular Carcinoma with Idarubicin: First Experience

GEP-NETS UPDATE: Interventional radiology: role in the treatment of liver metastases from GEP-NETs

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