Transarterial chemoembolization for pulmonary or mediastinal metastases from hepatocellular carcinoma

Hori, Akihiro; Ohira, Ryosuke; Nakamura, T.; Kawakami, Yasushi; Ueda, Shota; Torii, Masahiro; Kennoki, Norifumi; Hori, Shingo

doi:10.1259/bjr.20190407

Cited by 15 publications

(14 citation statements)

References 19 publications

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“…Vascular 3-D images effectively support selecting small branches arising from the aorta ( 30 ). Selective arterial contrast infusion CT is crucial in estimating individual arterial supply to the target lesions ( 11 , 26 , 27 ).…”

Section: Present Understanding On Arterial Management Of Lung Cancermentioning

confidence: 99%

Transarterial management of advance lung cancer

Hori¹,

Nakamura²,

Kennoki³

et al. 2021

Japanese Journal of Clinical Oncology

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Previous reports on transarterial treatment for lung cancer were reviewed. The bronchial arterial infusion therapy has a long history since 1964. Better local control with less doses of anti-neoplastic agents was warranted by trying transarterial administration to lung and mediastinal tumors. It is reported that both primary and metastatic tumors are fed by bronchial or other systemic arteries. The bronchial arterial embolization for hemoptysis has been introduced for clinical practice since 1973. Hemoptysis by not only benign but also malignant diseases has been well controlled by embolization. In recent decades, the technical elements for transarterial treatments have markedly improved. They make it possible to carry out precise procedures of selective catheter insertion to the tumor relating arteries. Current concepts of transarterial treatment, technical aspects and treatment outcomes are summarized. Tentative result from chemo-embolization for advanced lung cancer using recent catheter techniques was also described. It provides favorable local control and survival merits. It is considered that a population of lung cancer patients can benefit from transarterial management using small doses of anti-neoplastic agents, with less complications and less medical costs.

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Section: Present Understanding On Arterial Management Of Lung Cancermentioning

confidence: 99%

Transarterial management of advance lung cancer

Hori¹,

Nakamura²,

Kennoki³

et al. 2021

Japanese Journal of Clinical Oncology

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“…Not unexpectedly, it has been recently studied in patients with hepatocellular carcinoma to treat intrathoracic metastatic spread (77). This technique may be employed either alone or prior to ablation in a multimodality strategy, with the aim to improve local disease control by eliminating eventual micrometastasis and reducing the need for a larger safety margin during subsequent percutaneous ablation (63,78).…”

Section: Discussionmentioning

confidence: 99%

A narrative review on pulmonary metastases management by non-surgical local techniques: where do we stand?

Ierardi¹,

Carnevale²,

Chiarello³

et al. 2021

AME Surg J

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To analyze the existent evidence regarding local non-surgical therapies of lung metastases in terms of prognostic outcomes, control of disease and safety of treatment.Background: The rationale of local therapies for pulmonary metastases is either to increase the patient's chance of survival or cure the disease, depending on the origin and histology of the tumour. Metastasectomy still represents the preferred local treatment for lung metastases; however, due to the obvious drawbacks of almost any surgical intervention, many patients are not considered eligible for surgery.Methods: An extended search with a priori selection criteria was performed on the treatment of pulmonary metastases with stereotactic radiotherapy, percutaneous ablation via radiofrequency, microwaves, cryoablation (CRA) and chemoembolization. Two reviewers independently screened the titles and abstracts of all retrieved papers; the reference lists of eligible studies were checked with the aim to find further studies not identified by the initial search. After final selection, 52 original articles were included.Conclusions: A discrete number of minimally invasive non-surgical methods has been developed for tumor patients who are ineligible for surgical treatment. Among the available techniques, stereotactic radiotherapy and percutaneous ablation are currently the most commonly used local therapies. They have emerged as valid alternatives in case of surgical or medical inoperability, and may offer cancer patients the possibility for controlling unresectable pulmonary metastases with opportunities for improved survival.

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“…At the beginning of the procedure, the ethiodized oil and mitomycin were pumped through the three-way stopcock at vice versa. Previous studies have shown that lung tumors with more enhancement at arteriography are more likely to respond to chemoembolization, and a thorough search for bronchial and nonbronchial systemic arteries supplying the tumor is critical for achieving a good response after bronchial artery TACE (7,9,10). However, none of the previous studies have examined both the bronchial and pulmonary arteries.…”

Section: Ethiodized Oil and Mitomycin Emulsion Preparationmentioning

confidence: 99%

Bronchial or Pulmonary Artery Chemoembolization for Unresectable and Unablatable Lung Metastases: A Phase I Clinical Trial

Boas¹,

Kemeny²,

Sofocleous³

et al. 2021

Radiology

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M ost patients with lung metastases have unresectable disease (1). Patients with unresectable and unablatable lung metastases have poor survival and limited treatment options when the metastases stop responding to systemic chemotherapy (2).Transarterial chemoembolization (TACE) of the pulmonary or bronchial arteries is an emerging treatment option for large and multifocal lung tumors (Table E1 [online]). Like the liver, the lung has a dual blood supply. However, unlike liver tumors, which are mostly supplied by the hepatic artery, lung tumors can be supplied by either the bronchial artery or pulmonary artery (3). Response rates are 17% after pulmonary artery chemoembolization (4,5) and 39% after bronchial artery chemoembolization (6-8), bland embolization (9), or chemoinfusion (10-12). The highest reported response rates have been seen with primary lung cancer, treated via the bronchial artery (Table E1 [online]).A major limitation of existing studies of lung chemoembolization is the low response rate. We hypothesize that the low response rate is because of the dual blood supply of lung tumors. Lung tumors primarily supplied by the pulmonary artery will presumably have a low response rate to bronchial artery chemoembolization and Background: Lung chemoembolization is an emerging treatment option for lung tumors, but the optimal embolic, drug, and technique are unknown.Purpose: To determine the technical success rate and safety of bronchial or pulmonary artery chemoembolization of lung metastases using ethiodized oil, mitomycin, and microspheres. Materials and Methods:Patients with unresectable and unablatable lung, endobronchial, or mediastinal metastases, who failed systemic chemotherapy, were enrolled in this prospective, single-center, single-arm, phase I clinical trial (December 2019-September 2020). Pulmonary and bronchial angiography was performed to determine the blood supply to the lung metastases. Based on the angiographic findings, bronchial or pulmonary artery chemoembolization was performed using an ethiodized oil and mitomycin emulsion, followed by microspheres. The primary objectives were technical success rate and safety, according to the National Cancer Institute Common Terminology Criteria for Adverse Events. CIs of proportions were estimated with the equal-tailed Jeffreys prior interval, and correlations were evaluated with the Spearman test. Results:Ten participants (median age, 60 years; interquartile range, 52-70 years; six women) were evaluated. Nine of the 10 participants (90%) had lung metastases supplied by the bronchial artery, and one of the 10 participants (10%) had lung metastases supplied by the pulmonary artery. The technical success rate of intratumoral drug delivery was 10 of 10 (100%) (95% CI: 78, 100). There were no severe adverse events (95% CI: 0, 22). The response rate of treated tumors was one of 10 (10%) according to the Response Evaluation Criteria in Solid Tumors and four of 10 (40%) according to the PET Response Criteria in Solid Tumors. Ethiodized oil retention at 4-6 w...

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Transarterial chemoembolization for pulmonary or mediastinal metastases from hepatocellular carcinoma

Cited by 15 publications

References 19 publications

Transarterial management of advance lung cancer

Transarterial management of advance lung cancer

A narrative review on pulmonary metastases management by non-surgical local techniques: where do we stand?

Bronchial or Pulmonary Artery Chemoembolization for Unresectable and Unablatable Lung Metastases: A Phase I Clinical Trial

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