Two-Pronged Approach Offers Extended Survival for Some Cancer Patients With Mets to Liver
By Rachael Myers Lowe, cancerpage.com
German researchers have tested a new treatment combination for cancer patients with metastases to the liver who do not qualify for surgery because their liver tumors are too big - the size of a golf ball or larger.
The first step is a treatment called transarterial chemoembolization or TACE. TACE has been used to shrink liver tumors. It shrinks a tumor by cutting off its blood supply and subjecting it to chemotherapy. In this procedure, vessels leading into the tumor are blocked, the blood supply is reduced, and chemotherapy is administered only to the region of the tumor.
TACE is often combined with a follow-up treatment, either surgery to remove the now-smaller tumor, or some other procedure designed to kill remaining tumor cells. In this case, laser-induced thermotherapy (LITT) is the follow-up procedure. With LITT, optic fibers are inserted into the tumor and a laser heats the tumor to 100 degrees, killing the cancer cells.
Between 1999 and 2001, 162 cancer patients with metastases to the liver were enrolled in the trial conducted by Thomas J. Vogl, M.D., chairman of the Department of Diagnostic and Interventional Radiology at University Hospital Frankfurt, Germany. Their findings are published in the November 2003 issue of Radiology.
Participants received between two and seven TACE treatments. Just over 51% of the patients (82) had sufficient response to the TACE to move on to LITT. The other patients experienced either an insufficient tumor reduction (42) or disease progression (33.)
Patients who got both treatments lived, on average, eight months longer than those who only received TACE treatment.
The 82 patients who received both treatments represented a variety of primary cancers: 62 with metastatic colorectal cancer, 14 with metastatic breast cancer, and the other six with metastases from other primary cancers.
Both these treatments are localized and minimally invasive, thus reducing the side effects and according to the researchers, improving the patient’s quality of life.
"This treatment is local," Dr. Vogl said. "With local chemotherapy, the patients have no pain and don't lose their hair. This treatment allows us to be very aggressive in attacking the tumor, while maintaining a good quality of life for the patient," he said.
Vogl and his colleagues conclude that TACE combined with LITT can increase overall survival for some cancer patients whose disease has spread to the liver.
Radiology 2003; 229:457–464
Thanks to cancerpage.com, 10/03
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