Semin intervent Radiol 2017; 34(02): 087-091
DOI: 10.1055/s-0037-1601854
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Decision Making in Interventional Oncology: Intra-arterial Therapies for Metastatic Colorectal Cancer—Y90 and Chemoembolization

Alexandra H. Fairchild
1   Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
,
Sarah B. White
1   Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
› Author Affiliations
Further Information

Publication History

Publication Date:
01 June 2017 (online)

Abstract

Colorectal cancer is the third most common cancer in the United States and the liver is the most common site of metastatic disease. The presence and extent of hepatic metastases are a major prognostic indicator. Although surgical resection is the accepted first-line therapy for colorectal liver metastasis, only 20 to 25% of patients are eligible for resection due to the extent and location of disease. This article discusses the current role of transarterial therapies in the treatment of colorectal liver metastases.

 
  • References

  • 1 Bhutiani N, Martin II RCG. Transarterial therapy for colorectal liver metastases. Surg Clin North Am 2016; 96 (02) 369-391
  • 2 Tsai MS, Su YH, Ho MC. , et al. Clinicopathological features and prognosis in resectable synchronous and metachronous colorectal liver metastasis. Ann Surg Oncol 2007; 14 (02) 786-794
  • 3 Bentrem DJ, Dematteo RP, Blumgart LH. Surgical therapy for metastatic disease to the liver. Annu Rev Med 2005; 56: 139-156
  • 4 LeGolvan MP, Resnick M. Pathobiology of colorectal cancer hepatic metastases with an emphasis on prognostic factors. J Surg Oncol 2010; 102 (08) 898-908
  • 5 NCCN Guidelines Version 2. 2015 Colon Cancer, COL-7. Available at: https://www.scribd.com/document/264433721/NCCN-Colon . Accessed on April 5, 2017
  • 6 Schwarz RE, Berlin JD, Lenz HJ, Nordlinger B, Rubbia-Brandt L, Choti MA. Systemic cytotoxic and biological therapies of colorectal liver metastases: expert consensus statement. HPB (Oxford) 2013; 15 (02) 106-115
  • 7 Goldberg RM, Sargent DJ, Morton RF. , et al. Randomized controlled trial of reduced-dose bolus fluorouracil plus leucovorin and irinotecan or infused fluorouracil plus leucovorin and oxaliplatin in patients with previously untreated metastatic colorectal cancer: a North American Intergroup Trial. J Clin Oncol 2006; 24 (21) 3347-3353
  • 8 Thirion P, Michiels S, Pignon JP. , et al; Meta-Analysis Group in Cancer. Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: an updated meta-analysis. J Clin Oncol 2004; 22 (18) 3766-3775
  • 9 Foubert F, Matysiak-Budnik T, Touchefeu Y. Options for metastatic colorectal cancer beyond the second line of treatment. Dig Liver Dis 2014; 46 (02) 105-112
  • 10 Zhao J, Du CZ, Sun YS, Gu J. Patterns and prognosis of locally recurrent rectal cancer following multidisciplinary treatment. World J Gastroenterol 2012; 18 (47) 7015-7020
  • 11 Ji JH, Park SH, Lee J. , et al. Prospective phase II study of neoadjuvant FOLFOX6 plus cetuximab in patients with colorectal cancer and unresectable liver-only metastasis. Cancer Chemother Pharmacol 2013; 72 (01) 223-230
  • 12 Abdalla EK, Vauthey JN. Chemotherapy prior to hepatic resection for colorectal liver metastases: helpful until harmful?. Dig Surg 2008; 25 (06) 421-429
  • 13 Breedis C, Young G. The blood supply of neoplasms in the liver. Am J Pathol 1954; 30 (05) 969-977
  • 14 Collins JM. Pharmacologic rationale for regional drug delivery. J Clin Oncol 1984; 2 (05) 498-504
  • 15 Llovet JM, Real MI, Montaña X. , et al; Barcelona Liver Cancer Group. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359 (9319): 1734-1739
  • 16 Lo CM, Ngan H, Tso WK. , et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002; 35 (05) 1164-1171
  • 17 Lang EK, Brown Jr CL. Colorectal metastases to the liver: selective chemoembolization. Radiology 1993; 189 (02) 417-422
  • 18 Tellez C, Benson III AB, Lyster MT. , et al. Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature. Cancer 1998; 82 (07) 1250-1259
  • 19 Albert M, Kiefer MV, Sun W. , et al. Chemoembolization of colorectal liver metastases with cisplatin, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol. Cancer 2011; 117 (02) 343-352
  • 20 Vogl TJ, Gruber T, Balzer JO, Eichler K, Hammerstingl R, Zangos S. Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study. Radiology 2009; 250 (01) 281-289
  • 21 Lewis AL, Gonzalez MV, Lloyd AW. , et al. DC bead: in vitro characterization of a drug-delivery device for transarterial chemoembolization. J Vasc Interv Radiol 2006; 17 (2 Pt 1): 335-342
  • 22 Taylor RR, Tang Y, Gonzalez MV, Stratford PW, Lewis AL. Irinotecan drug eluting beads for use in chemoembolization: in vitro and in vivo evaluation of drug release properties. Eur J Pharm Sci 2007; 30 (01) 7-14
  • 23 Bower M, Metzger T, Robbins K. , et al. Surgical downstaging and neo-adjuvant therapy in metastatic colorectal carcinoma with irinotecan drug-eluting beads: a multi-institutional study. HPB (Oxford) 2010; 12 (01) 31-36
  • 24 Martin RCG, Joshi J, Robbins K. , et al. Hepatic intra-arterial injection of drug-eluting bead, irinotecan (DEBIRI) in unresectable colorectal liver metastases refractory to systemic chemotherapy: results of multi-institutional study. Ann Surg Oncol 2011; 18 (01) 192-198
  • 25 Fiorentini G, Aliberti C, Tilli M. , et al. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res 2012; 32 (04) 1387-1395
  • 26 Cunningham D, Humblet Y, Siena S. , et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 2004; 351 (04) 337-345
  • 27 Hurwitz H, Fehrenbacher L, Novotny W. , et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350 (23) 2335-2342
  • 28 Chen HX, Mooney M, Boron M. , et al. Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. J Clin Oncol 2006; 24 (21) 3354-3360
  • 29 Marqués A, García R, Gómez F, Giammaria F. Ultrasound-guided paravertebral block for management of abdominal pain after transarterial embolization using drug-eluting beads loaded with irinotecan. J Vasc Interv Radiol 2013; 24 (09) 1416-1417
  • 30 Geschwind JF, Salem R, Carr BI. , et al. Yttrium-90 microspheres for the treatment of hepatocellular carcinoma. Gastroenterology 2004; 127 (05) (Suppl. 01) S194-S205
  • 31 Saxena A, Bester L, Shan L. , et al. A systematic review on the safety and efficacy of yttrium-90 radioembolization for unresectable, chemorefractory colorectal cancer liver metastases. J Cancer Res Clin Oncol 2014; 140: 537-547
  • 32 Lewandowski RJ, Memon K, Mulcahy MF. , et al. Twelve-year experience of radioembolization for colorectal hepatic metastases in 214 patients: survival by era and chemotherapy. Eur J Nucl Med Mol Imaging 2014; 41 (10) 1861-1869
  • 33 Van Hazel G, Blackwell A, Anderson J. , et al. Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer. J Surg Oncol 2004; 88 (02) 78-85
  • 34 van Hazel GA, Heinemann V, Sharma NK. , et al. SIRFLOX: randomized phase iii trial comparing first-line mFOLFOX6 (plus or minus bevacizumab) versus mFOLFOX6 (plus or minus bevacizumab) plus selective internal radiation therapy in patients with metastatic colorectal cancer. J Clin Oncol 2016; 34 (15) 1723-1731
  • 35 Georgiades CS, Hong K, Geschwind JF. Pre- and postoperative clinical care of patients undergoing interventional oncology procedures: a comprehensive approach to preventing and mitigating complications. Tech Vasc Interv Radiol 2006; 9 (03) 113-124
  • 36 Chung JW, Park JH, Han JK. , et al. Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology 1996; 198 (01) 33-40
  • 37 Buijs M, Vossen JA, Frangakis C. , et al. Nonresectable hepatocellular carcinoma: long-term toxicity in patients treated with transarterial chemoembolization--single-center experience. Radiology 2008; 249 (01) 346-354
  • 38 Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S. Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 1983; 148 (02) 397-401
  • 39 Sangro B, Gil-Alzugaray B, Rodriguez J. , et al. Liver disease induced by radioembolization of liver tumors: description and possible risk factors. Cancer 2008; 112 (07) 1538-1546
  • 40 Kim W, Clark TW, Baum RA, Soulen MC. Risk factors for liver abscess formation after hepatic chemoembolization. J Vasc Interv Radiol 2001; 12 (08) 965-968
  • 41 Mezhir JJ, Fong Y, Fleischer D. , et al. Pyogenic abscess after hepatic artery embolization: a rare but potentially lethal complication. J Vasc Interv Radiol 2011; 22 (02) 177-182
  • 42 Kim HK, Chung YH, Song BC. , et al. Ischemic bile duct injury as a serious complication after transarterial chemoembolization in patients with hepatocellular carcinoma. J Clin Gastroenterol 2001; 32 (05) 423-427
  • 43 Patel S, Tuite CM, Mondschein JI, Soulen MC. Effectiveness of an aggressive antibiotic regimen for chemoembolization in patients with previous biliary intervention. J Vasc Interv Radiol 2006; 17 (12) 1931-1934
  • 44 Cholapranee A, van Houten D, Deitrick G. , et al. Risk of liver abscess formation in patients with prior biliary intervention following yttrium-90 radioembolization. Cardiovasc Intervent Radiol 2015; 38 (02) 397-400
  • 45 Salem R, Lewandowski RJ, Atassi B. , et al. Treatment of unresectable hepatocellular carcinoma with use of 90Y microspheres (TheraSphere): safety, tumor response, and survival. J Vasc Interv Radiol 2005; 16 (12) 1627-1639
  • 46 Riaz A, Lewandowski RJ, Kulik LM. , et al. Complications following radioembolization with yttrium-90 microspheres: a comprehensive literature review. J Vasc Interv Radiol 2009; 20 (09) 1121-1130 , quiz 1131
  • 47 Salem R, Parikh P, Atassi B. , et al. Incidence of radiation pneumonitis after hepatic intra-arterial radiotherapy with yttrium-90 microspheres assuming uniform lung distribution. Am J Clin Oncol 2008; 31 (05) 431-438