Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature

Claudia Tellez, Al B. Benson*, Michael T. Lyster, Mark Talamonti, John Shaw, Michael A. Braun, Albert A. Nemcek, Robert L. Vogelzang

*Corresponding author for this work

Research output: Contribution to journalArticle

154 Citations (Scopus)

Abstract

BACKGROUND. Hepatic artery chemoembolization represents an alternative treatment for patients whose neoplastic lesions are not amenable or have become refractory to other treatment modalities. This project was designed to test the feasibility of regional chemoembolization for patients with colorectal carcinoma metastasis to the liver who had experienced failure with one or more systemic treatments. METHODS. Thirty patients who met the study entry criteria underwent one to three hepatic artery chemoembolizations. The chemoembolization regimen consisted of an injection of a bovine collagen material with cisplatin (10 mg/mL), doxorubucin (3 mg/mL), and mitomycin C (3 mg/mL). Repeat treatments were performed at 6- to 8-week intervals. RESULTS. Radiologic responses, as measured by a decrease in lesion density of at least 75% of the lesion or a 25% decrease in the size of the lesion, occurred in 63% of the cases. A decrease of at least 25% of the baseline carcinoembryonic antigen level occurred in 95% of the cases. All responses were transient. Median survival for all 30 patients was 8.6 months after the initiation of chemoembolization and 29 months after the initial diagnosis of metastasis to the liver. Common toxicities included a 'postembolization syndrome', which consisted of fever > 101 °F (83%), pain in the right upper quadrant (100%), nausea, and vomiting. Lethargy was a common occurrence (in 60+% of cases) and lasted up to 6 weeks. Hematologic toxicities included leukocytosis, anemia, and thrombocytopenia. Conclusions. Chemoembolization is a feasible treatment modality for patients with colorectal carcinoma metastasis to the liver who have experienced failure with other systemic treatments. It results in high response rates with transient mild-to-moderate toxicity. Responses are measured in months, however, and all patients have eventual progression of disease. Patients who are able to undergo three or more chemoembolization procedures may receive the most clinical benefit.

Original languageEnglish (US)
Pages (from-to)1250-1259
Number of pages10
JournalCancer
Volume82
Issue number7
DOIs
StatePublished - Apr 1 1998

Fingerprint

Colorectal Neoplasms
Liver
Hepatic Artery
Neoplasm Metastasis
Therapeutics
Lethargy
Carcinoembryonic Antigen
Leukocytosis
Mitomycin
Thrombocytopenia
Nausea
Cisplatin
Vomiting
Disease Progression
Anemia
Fever
Collagen
Pain
Injections
Survival

Keywords

  • Angiostat
  • Chemoembolization
  • Cisplatin
  • Colorectal
  • Doxorubicin
  • Liver
  • Metastatic
  • Mitomycin c

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Tellez, Claudia ; Benson, Al B. ; Lyster, Michael T. ; Talamonti, Mark ; Shaw, John ; Braun, Michael A. ; Nemcek, Albert A. ; Vogelzang, Robert L. / Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature. In: Cancer. 1998 ; Vol. 82, No. 7. pp. 1250-1259.
@article{76c07772984e4262be9660a646d527cd,
title = "Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature",
abstract = "BACKGROUND. Hepatic artery chemoembolization represents an alternative treatment for patients whose neoplastic lesions are not amenable or have become refractory to other treatment modalities. This project was designed to test the feasibility of regional chemoembolization for patients with colorectal carcinoma metastasis to the liver who had experienced failure with one or more systemic treatments. METHODS. Thirty patients who met the study entry criteria underwent one to three hepatic artery chemoembolizations. The chemoembolization regimen consisted of an injection of a bovine collagen material with cisplatin (10 mg/mL), doxorubucin (3 mg/mL), and mitomycin C (3 mg/mL). Repeat treatments were performed at 6- to 8-week intervals. RESULTS. Radiologic responses, as measured by a decrease in lesion density of at least 75{\%} of the lesion or a 25{\%} decrease in the size of the lesion, occurred in 63{\%} of the cases. A decrease of at least 25{\%} of the baseline carcinoembryonic antigen level occurred in 95{\%} of the cases. All responses were transient. Median survival for all 30 patients was 8.6 months after the initiation of chemoembolization and 29 months after the initial diagnosis of metastasis to the liver. Common toxicities included a 'postembolization syndrome', which consisted of fever > 101 °F (83{\%}), pain in the right upper quadrant (100{\%}), nausea, and vomiting. Lethargy was a common occurrence (in 60+{\%} of cases) and lasted up to 6 weeks. Hematologic toxicities included leukocytosis, anemia, and thrombocytopenia. Conclusions. Chemoembolization is a feasible treatment modality for patients with colorectal carcinoma metastasis to the liver who have experienced failure with other systemic treatments. It results in high response rates with transient mild-to-moderate toxicity. Responses are measured in months, however, and all patients have eventual progression of disease. Patients who are able to undergo three or more chemoembolization procedures may receive the most clinical benefit.",
keywords = "Angiostat, Chemoembolization, Cisplatin, Colorectal, Doxorubicin, Liver, Metastatic, Mitomycin c",
author = "Claudia Tellez and Benson, {Al B.} and Lyster, {Michael T.} and Mark Talamonti and John Shaw and Braun, {Michael A.} and Nemcek, {Albert A.} and Vogelzang, {Robert L.}",
year = "1998",
month = "4",
day = "1",
doi = "10.1002/(SICI)1097-0142(19980401)82:7<1250::AID-CNCR7>3.0.CO;2-J",
language = "English (US)",
volume = "82",
pages = "1250--1259",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature. / Tellez, Claudia; Benson, Al B.; Lyster, Michael T.; Talamonti, Mark; Shaw, John; Braun, Michael A.; Nemcek, Albert A.; Vogelzang, Robert L.

In: Cancer, Vol. 82, No. 7, 01.04.1998, p. 1250-1259.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature

AU - Tellez, Claudia

AU - Benson, Al B.

AU - Lyster, Michael T.

AU - Talamonti, Mark

AU - Shaw, John

AU - Braun, Michael A.

AU - Nemcek, Albert A.

AU - Vogelzang, Robert L.

PY - 1998/4/1

Y1 - 1998/4/1

N2 - BACKGROUND. Hepatic artery chemoembolization represents an alternative treatment for patients whose neoplastic lesions are not amenable or have become refractory to other treatment modalities. This project was designed to test the feasibility of regional chemoembolization for patients with colorectal carcinoma metastasis to the liver who had experienced failure with one or more systemic treatments. METHODS. Thirty patients who met the study entry criteria underwent one to three hepatic artery chemoembolizations. The chemoembolization regimen consisted of an injection of a bovine collagen material with cisplatin (10 mg/mL), doxorubucin (3 mg/mL), and mitomycin C (3 mg/mL). Repeat treatments were performed at 6- to 8-week intervals. RESULTS. Radiologic responses, as measured by a decrease in lesion density of at least 75% of the lesion or a 25% decrease in the size of the lesion, occurred in 63% of the cases. A decrease of at least 25% of the baseline carcinoembryonic antigen level occurred in 95% of the cases. All responses were transient. Median survival for all 30 patients was 8.6 months after the initiation of chemoembolization and 29 months after the initial diagnosis of metastasis to the liver. Common toxicities included a 'postembolization syndrome', which consisted of fever > 101 °F (83%), pain in the right upper quadrant (100%), nausea, and vomiting. Lethargy was a common occurrence (in 60+% of cases) and lasted up to 6 weeks. Hematologic toxicities included leukocytosis, anemia, and thrombocytopenia. Conclusions. Chemoembolization is a feasible treatment modality for patients with colorectal carcinoma metastasis to the liver who have experienced failure with other systemic treatments. It results in high response rates with transient mild-to-moderate toxicity. Responses are measured in months, however, and all patients have eventual progression of disease. Patients who are able to undergo three or more chemoembolization procedures may receive the most clinical benefit.

AB - BACKGROUND. Hepatic artery chemoembolization represents an alternative treatment for patients whose neoplastic lesions are not amenable or have become refractory to other treatment modalities. This project was designed to test the feasibility of regional chemoembolization for patients with colorectal carcinoma metastasis to the liver who had experienced failure with one or more systemic treatments. METHODS. Thirty patients who met the study entry criteria underwent one to three hepatic artery chemoembolizations. The chemoembolization regimen consisted of an injection of a bovine collagen material with cisplatin (10 mg/mL), doxorubucin (3 mg/mL), and mitomycin C (3 mg/mL). Repeat treatments were performed at 6- to 8-week intervals. RESULTS. Radiologic responses, as measured by a decrease in lesion density of at least 75% of the lesion or a 25% decrease in the size of the lesion, occurred in 63% of the cases. A decrease of at least 25% of the baseline carcinoembryonic antigen level occurred in 95% of the cases. All responses were transient. Median survival for all 30 patients was 8.6 months after the initiation of chemoembolization and 29 months after the initial diagnosis of metastasis to the liver. Common toxicities included a 'postembolization syndrome', which consisted of fever > 101 °F (83%), pain in the right upper quadrant (100%), nausea, and vomiting. Lethargy was a common occurrence (in 60+% of cases) and lasted up to 6 weeks. Hematologic toxicities included leukocytosis, anemia, and thrombocytopenia. Conclusions. Chemoembolization is a feasible treatment modality for patients with colorectal carcinoma metastasis to the liver who have experienced failure with other systemic treatments. It results in high response rates with transient mild-to-moderate toxicity. Responses are measured in months, however, and all patients have eventual progression of disease. Patients who are able to undergo three or more chemoembolization procedures may receive the most clinical benefit.

KW - Angiostat

KW - Chemoembolization

KW - Cisplatin

KW - Colorectal

KW - Doxorubicin

KW - Liver

KW - Metastatic

KW - Mitomycin c

UR - http://www.scopus.com/inward/record.url?scp=0032055514&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032055514&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1097-0142(19980401)82:7<1250::AID-CNCR7>3.0.CO;2-J

DO - 10.1002/(SICI)1097-0142(19980401)82:7<1250::AID-CNCR7>3.0.CO;2-J

M3 - Article

C2 - 9529016

AN - SCOPUS:0032055514

VL - 82

SP - 1250

EP - 1259

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 7

ER -