Short-term effectiveness of radiochemoembolization for selected hepatic metastases with a combination protocol

Table 4 Studies on chemoembolization for metastatic hepatic lesions with cisplatin, doxorubicin and mitomycin

Study	Primary diagnosis	Procedure	Chemotherapeutic agents	Embolic material	Number of patients	Response criteria	Response measured at months treatment	Response rate	Complications
Diaco et al[58], 1995	Carcinoid tumor	Chemoembolization	Cisplatin, doxorubicin, mitomycin	NA	10	WHO	NA	Partial response (60%), stable disease (30%)	NA
Drougas et al[59], 1998	Carcinoid tumor	Chemoembolization	Doxorubicin (60 mg), cisplatin (100 mg), and mitomycin (30 mg)	Polyvinyl alcohol	131	WHO	3	Partial response in 1 (8%), minimal response in 10 (77%), stable disease in 1 (8%), progressive disease in 1 (8%)	Nausea/vomiting in 100%, increased transaminases in 100%, pain in 100%, fever in 29%, myelosuppression in 29%, arterial thrombosis in 8%, dysrhythmia in 8%, mental status changes in 4%
Tellez et al[60], 1998	Colorectal carcinoma	Chemoembolization	Cisplatin, doxorubicin, mitomycin	Angiostat (a bovine collagen material)	27	Designed by authors2	NA	Radiological response in 17 of 27 patients (63%)	Fever in 83%, RUQ pain in 100%, nausea/vomiting in 83%, gastritis in 17%, lethargy in 60%
Buijs et al[45], 2007	Breast cancer	Chemoembolization	Doxorubicin (50 mg), cisplatin (100 mg), and mitomycin (10 mg) in a 1:1 mixture with iodized oil	300- to 500-μm embolic microspheres	143	RECIST	1-2	No complete response, partial response in 7 lesions (26%)6	NA
Ruutiainen et al[61], 2007	Neuroendocrine tumor	Chemoembolization	Cisplatin, doxorubicin, mitomycin in a mixture with iodized oil	150- to 250-μm granular polyvinyl alcohol particles	44	RECIST	1	88% partial response/stable disease	High incidence of postembolization syndrome, severe pain in 3 sessions, severe nausea in 1 session, severe vomiting in 1 session, severe GGT/ALP elevation in 4 sessions, severe AST elevation in 1 session, severe ALT elevation in 1 session, severe infection in 1 session
Artinyan et al[44], 2008	Mixed	Chemoembolization	Doxorubicin (50 mg), mitomycin (10 mg), and cisplatin (150 mg)	Polyvinyl alcohol microspheres (300-700 μm)	614	RECIST	At least 1	Partial response in 9 (14.8%), progressive disease in 3 (4.9%)	Bleeding in 2 patients (2%), renal failure in 6 patients (5%), hepatic failure in 7 patients (6%), infection in 3 patients (3%), mortality in 30 d in 7 patients (6%)
Buijs et al[48], 2008	Ocular melanoma	Chemoembolization	Doxorubicin (50 mg), cisplatin (100 mg), and mitomycin (10 mg) in a 1:1 mixture with iodized oil	300- to 500-μm embolic microspheres	65	RECIST	1-2	No complete response, partial response in 8 lesions6	NA
Albert et al[62], 2011	Colorectal carcinoma	Chemoembolization	Cisplatin, doxorubicin, mitomycin in a mixture with ethiodized oil	Polyvinyl alcohol	956	RECIST	NA	Partial response in 9 (14.8%), stable disease in 49 (80.3%), progressive disease in 3 (4.9%)	NA

¹There were 15 patients at first, however one died before the follow up imaging and one patient’s follow-up was out of state. Three patients only received hepatic artery embolization;

²at least 75% decrease in the density of lesions consistent with necrosis or 25% decrease in the size of the lesions without the development of concomitant lesions;

³twenty-seven lesions;

⁴the total number of patients was 119, but for 61 patients the response evaluation criteria in solid tumors (RECIST) criteria were available;

⁵twenty-one lesions, reporting by patient, all patients were considered non-responders to transcatheter arterial chemoembolization because the total tumor burden did not decrease by 30% in any given patient;

⁶ninety-five of 141 treatment cycles were evaluable for response. The response rate is calculated per treatment cycle. NA: Not available; RUQ: Right upper quadrant; WHO: World Health Organization; GGT/ALP: Gamma-glutamyl transpeptidase/alkaline phosphatase; AST/ALT: Aspartate aminotransferase/alanine aminotransferase.