caa a22 4500 445338490 CHVBK 20180317142804.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1333-4 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1333-4 Precision Hepatic Arterial Irinotecan Therapy in the Treatment of Unresectable Intrahepatic Cholangiocellular Carcinoma: Optimal Tolerance and Prolonged Overall Survival [Elektronische Daten] [Suzanne Schiffman, Tiffany Metzger, Gregory Dubel, Tomas Andrasina, Ivan Kralj, Cliff Tatum, Kelly McMasters, Charles Scoggins, Robert Martin] Background: Unresectable intrahepatic cholangiocellular carcinoma (ICC) carries a poor prognosis, and there are few chemotherapeutic treatments to prolong survival. The purpose of this study was to assess the efficacy of drug-eluting bead (DEB) therapy by transarterial infusion for unresectable ICC. Methods: A prospective multicenter study of ICC patients who received hepatic arterial DEB therapy. Results: Twenty-four patients with unresectable ICC were treated with DEB. Ten patients (41.6%) had recurrent ICC after prior radiofrequency ablation (n=3) or hepatectomy (n=7). Twenty patients (80%) had received prior chemotherapy, mostly of gemcitabine (n=8) or Eloxatin (n=6). The percent of overall liver involvement was<25% (n=8), 26% to 50% (n=11), and>50% (n=4). Ten patients (40%) had sites of extrahepatic disease located at lymph nodes (n=5), bone (n=2), peritoneum (n=1), lung (n=1), and mouth (n=1). A total of 42 DEB treatments were administered. Eight were administered in combination with systemic chemotherapy of FOLFOX (n=4) or Gemzar (n=4). Twelve patients (48%) received a second treatment, and 4 patients (16%) received a third treatment. The median length of stay was 23h (23-72h). Eleven adverse reactions (26.2%) were reported. Of these, 7 (63.6%) were minor (less than grade 3). One patient died from hepatorenal syndrome. The disease of one patient was downstaged to resection. After a median follow-up of 13.6months, the median overall survival of a multitherapeutic regimen with DEB therapy was significantly greater than chemotherapy alone (17.5 vs. 7.4months; P=0.02). Conclusions: Bead therapy is safe and effective in patients with unresectable ICC. There is a marked survival benefit when DEB therapy is used as adjunctive therapy. Society of Surgical Oncology, 2010 Schiffman Suzanne Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut Metzger Tiffany Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut Dubel Gregory Division of Interventional Radiology, Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI, USA aut Andrasina Tomas Department of Radiology, FN Brno a LF MU, Brno, Czech Republic aut Kralj Ivan Diakonissenkrankenhaus, Klinik für Radiologie, Interventionsradiologie und Nuklearmedizin, Karlsruhe, Germany aut Tatum Cliff Norton Radiology, Norton Healthcare, Louisville, KY, USA aut McMasters Kelly Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut Scoggins Charles Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut Martin Robert Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 431-438 1068-9265 18:2<431 2011 18 10434 https://doi.org/10.1245/s10434-010-1333-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1333-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schiffman Suzanne Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut NATIONALLICENCE 700 1- Metzger Tiffany Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut NATIONALLICENCE 700 1- Dubel Gregory Division of Interventional Radiology, Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI, USA aut NATIONALLICENCE 700 1- Andrasina Tomas Department of Radiology, FN Brno a LF MU, Brno, Czech Republic aut NATIONALLICENCE 700 1- Kralj Ivan Diakonissenkrankenhaus, Klinik für Radiologie, Interventionsradiologie und Nuklearmedizin, Karlsruhe, Germany aut NATIONALLICENCE 700 1- Tatum Cliff Norton Radiology, Norton Healthcare, Louisville, KY, USA aut NATIONALLICENCE 700 1- McMasters Kelly Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut NATIONALLICENCE 700 1- Scoggins Charles Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut NATIONALLICENCE 700 1- Martin Robert Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 431-438 1068-9265 18:2<431 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer