Thomas Josef Vogl MD, Presenter: Nothing to Disclose

Tatjana Gruber BMedSc, Abstract Co-Author: Nothing to Disclose

Katrin Eichler MD, Abstract Co-Author: Nothing to Disclose

Stefan Zangos MD, Abstract Co-Author: Nothing to Disclose

To evaluate the tolerability and efficacy of transarterial chemoembolization (TACE) using different drug combinations in the treatment of liver metastases in breast cancer patients concerning local tumor control and survival.

217 patients with unresectable hepatic metastases of breast cancer were repeatedly treated with TACE in 4-week intervals. In total, 1,310 chemoembolizations were performed with a mean of 6 sessions per patient. At the time of the first chemoembolization, the average age of the patients was 52.2 years (range, 29-81 years). While 62.2% of the patients showed multiple metastases, 8.8% had 1 metastasis, 9.2% had 2 metastases and 19.8% had 3 to 4 metastases. The local chemotherapy protocol consisted of only mitomycin C (n=76), mitomycin C with gemcitabine (n=110), and only gemcitabine (n=21). Embolization was performed with lipiodol and starch microspheres for vessel occlusion. Tumor response was evaluated by magnetic resonance imaging (MRI). The change in size was calculated and the response was evaluated according to the RECIST criteria. Survival rates from the first diagnosis and the first TACE session were both calculated according to the Kaplan-Meier method to obtain the median survival.

Local tumor control evaluation resulted in a partial response in 13.4% of cases, stable disease in 50.2%, and progressive disease in 36.4%. During therapy the clinical situation changed, 142 patients (65.4%) were treated palliatively, 34 patients (15.7%) symptomatically, and 60 patients (18.9%) neoadjuvantly. The 1-year survival rate after TACE was 68%, the 2-year survival rate was reduced to 43%. The median survival time from the date of diagnosis was 8.2 years (according to Kaplan-Maier), the median survival time from the start of TACE treatment was 19 months. The median survival time of the palliative group was 19 months, the symptomatic group 6 months, and the neoadjuvant group 44.3 months.

TACE is an effective minimal-invasive therapy for treatment of liver metastases in breast cancer patients.

In liver metastases of breast cancer repeated chemoembolization allows a relevant palliative treatment option.

Vogl, T, Gruber, T, Eichler, K, Zangos, S, Repeated Transarterial Chemoembolization (TACE) in the Treatment of Patients with Liver Metastases of Breast Cancer.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5003811.html