Giulia Agostini, Presenter: Nothing to Disclose

Massimo Venturini MD, Abstract Co-Author: Nothing to Disclose

Stefano Cappio MD, Abstract Co-Author: Nothing to Disclose

Giulia Cammi, Abstract Co-Author: Nothing to Disclose

Francesco Aldo De Cobelli MD, Abstract Co-Author: Nothing to Disclose

Alessandro Del Maschio MD, Abstract Co-Author: Nothing to Disclose

TACE with drug-eluting beads is routinely performed using Doxorubicin and Irinotecan in the treatment of HCC and hepatic metastases from colorectal cancer, respectively. Conversely, there is no specific drug indication in the treatment of other hypervascular liver metastases. Aim of our study was to compare the efficacy of DEBIRI vs. DEBDOX in the treatment of unresectable hepatic metastases from cholangiocarcinoma.  

In 2013, 10 patients affected by multiple cholangiocarcinoma hepatic metastases, resistant to the first line CT regimen, were enrolled: 5 were submitted to lobar/segmental TACE with DEBIRI (100mg Irinotecan/1vial) and 5 with DEBDOX (50mg Doxorubicina/1vial), performed every 3 weeks. Patients treated with DEBIRI received ant-pain pre-medication consisting of a 30 mg of morphine and 3-4 ml of intra-arterial lidocaine. All the procedures were performed with a trans-femoral approach using a microcatheter. Complications and efficacy of the two different types of treatment were assessed with contrast-enhanced MDCT (RECIST and mRECIST criteria) performed at baseline and 72 hours after each procedure.

A total of 32 TACE were performed (mean: 3,2 TACE/patient). All the treatments were well tolerated, with one only case of asymptomatic cholecystitis spontaneously recovered. Response rates assessed at the end of the treatment cycle of patients treated with DEBDOX were 5/5 PD while the ones of the patients treated with DEBIRI were 2/5 PR, 2/5 SD and 1/5 PD, with the appearance of a variable necrosis percentage.  

Anti-pain drug administration in patients treated with DEBIRI and the use of the microcatheter lead to a good treatment tolerability and a low complication rate. In our experience, DEBIRI was more effective than DEBDOX as a second line treatment of hepatic metastases from cholangiocarcinoma, an extremely aggressive malignancy.

In our experience, DEBIRI was more effective than DEBDOX as a second line treatment of hepatic metastases from cholangiocarcinoma.

Agostini, G, Venturini, M, Cappio, S, Cammi, G, De Cobelli, F, Del Maschio, A, Chemoembolization with Dc Beads Preloaded with Irinotecan (DEBIRI) vs. Doxorubicin (DEBDOX) as a Second Line Treatment for Liver Metastases from Cholangiocarcinoma: Technical Aspects, Complications, and Efficacy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019114.html