We performed a phase II clinical trial of intra-arterial hepatic chemoembolization (TACE) with irinotecan-eluting beads in 20 patients affected by liver metastases from colorectal cancer (CRC) as palliative setting. We observed a high response rate (80%), with reduction of lesional contrast enhancement in all responding patients. We developed an intensive treatment with intra-arterial lidocaine and post-procedure supportive therapy to reduce acute pain and toxic effects and post embolization syndrome due to acute hypoxia. Due to this support TACE was well tolerated by most patients with a median duration of hospitalization of 3 days (range 1-10). The most important adverse event was abdominal pain. Supportive treatment with antibiotic and antiemetic prophylaxis, and intravenous hydratation is strictly necessary until stabilization of serum levels of transaminases and to prevent infections. Major analgesic as morphine and intra-arterial lidocaine might be used before the procedure. Our results suggest that TACE using irinotecan-eluting beads is feasible in pretreated patients with liver metastases from CRC adopting an adequate supportive therapy to reduce side effects, particularly those linked to acute hypoxia induced by TACE.

Part B: Example of method for reducing side effects of induced acute hypoxia by tace for treating liver metastases, phase II clinical trial

GUADAGNI, Stefano
2009-01-01

Abstract

We performed a phase II clinical trial of intra-arterial hepatic chemoembolization (TACE) with irinotecan-eluting beads in 20 patients affected by liver metastases from colorectal cancer (CRC) as palliative setting. We observed a high response rate (80%), with reduction of lesional contrast enhancement in all responding patients. We developed an intensive treatment with intra-arterial lidocaine and post-procedure supportive therapy to reduce acute pain and toxic effects and post embolization syndrome due to acute hypoxia. Due to this support TACE was well tolerated by most patients with a median duration of hospitalization of 3 days (range 1-10). The most important adverse event was abdominal pain. Supportive treatment with antibiotic and antiemetic prophylaxis, and intravenous hydratation is strictly necessary until stabilization of serum levels of transaminases and to prevent infections. Major analgesic as morphine and intra-arterial lidocaine might be used before the procedure. Our results suggest that TACE using irinotecan-eluting beads is feasible in pretreated patients with liver metastases from CRC adopting an adequate supportive therapy to reduce side effects, particularly those linked to acute hypoxia induced by TACE.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11697/110322
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