Skip to main content
Log in

Chemoembolization (TACE) of Unresectable Intrahepatic Cholangiocarcinoma with Slow-Release Doxorubicin-Eluting Beads: Preliminary Results

CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliative care or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100–150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven patients are alive, with a median survival of 13 months. TACE was well tolerated by all patients. One patient developed hepatic abscess requiring antibiotic therapy. No evidence of marrow toxicity has been reported. Only one of nine patients treated with chemotherapy or palliative care is alive (with a median survival of 7 months in this group of patients). In conclusion, we suggest that doxorubicin-eluting beads TACE is a feasible and effective treatment in patients with UCH. Survival seems to be clearly prolonged in the treated group with respect to the palliative group. We consider that doxorubicin-eluting beads TACE of 100–150 mg may be an appropriate palliative therapy for these patients. Further studies are warranted to confirm these interesting preliminary data.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Onles Mj, Erlich R (2004) A review and update on cholangiocarcinoma. Oncology 66(3):167–179

    Article  Google Scholar 

  2. Anderson CD, Wright Pinson C, Berlin J, Chari RS (2004) Diagnosis and treatment of cholangiocarcinoma. Oncologist 9(1):43–57

    Article  PubMed  Google Scholar 

  3. Tan JC, Coburn NG, Baxter NN, Kiss A, Law CH (2008) Surgical management of intrahepatic cholangiocarcinoma—a population-based study. Ann Surg Oncol 16(2):600–608

    Google Scholar 

  4. Cunningham SC, Choti MA, Bellavance EC, Pawlik TM (2007) Palliation of hepatic tumors. Surg Oncol 16(4):277–291

    Article  PubMed  Google Scholar 

  5. Mambrini A, Guglielmi A, Pacetti P, Iacono C, Torri T, Auci A, Nicoli N, Orlandi M, Guadagni S, Fiorentini G, Cantore M (2007) Capecitabine plus hepatic intra-arterial epirubicin and cisplatin in unresectable biliary cancer: a phase II study. Anticancer Res 27(4C):3009–3013

    PubMed  CAS  Google Scholar 

  6. Cammà C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, Andreone P, Craxì A, Cottone M (2002) Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology 224:47–54

    Article  PubMed  Google Scholar 

  7. Gusani N, Balaa F, Steel J, Geller DA, Marsh JW, Zajko AB, Carr BI, Gamblin TC (2008) Treatment of unresectable cholangiocarcinoma with gemcitabine-based transcatheter arterial chemoembolization (TACE): a single-institution experience. J Gastrointest Surg 12(1):129–137

    Google Scholar 

  8. Burger I, Hong K, Schulick R, Georgiades C, Thuluvath P, Choti M, Kamel I, Geschwind JF et al (2005) Transcatheter arterial Chemoembolization in unresectable Cholangiocarcinoma: initial experience in a single institution. J Vasc Interv Radiol 16(3):353–361

    PubMed  Google Scholar 

  9. Herber S, Otto G, Schneider J, Manzl N, Kummer I, Kanzler S, Schuchmann A, Thies J, Düber C, Pitton M (2007) Transarterial chemoembolization (TACE) for inoperable intrahepatic cholangiocarcinoma. CardioVasc Interv Radiol 30(6):1156–1165

    Article  CAS  Google Scholar 

  10. Lewis AL, Taylor RR, Hall B et al (2006) Pharmacokinetic and safety study of doxorubicin-eluting beads in a porcine model of hepatic arterial chemoembolization. J Vasc Interv Radiol 17:1335–1343

    Article  PubMed  Google Scholar 

  11. Varela M, Real IR, Burrel M, Forner A, Sala M, Brunet M, Ayuso C, Castells L, Montañá X, Llovet JM, Bruix J (2007) Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy anf doxorubicin pharmacokinetics. J Hepatol 46(3):474–481

    Article  PubMed  CAS  Google Scholar 

  12. Aliberti C, Tilli M, Benea G, Fiorentini G (2006) Trans-arterial chemoembolization (TACE) of liver metastases from colorectal cancer using irinotecan-eluting beads: preliminary results. Anticancer Res 26:3793–3795

    PubMed  CAS  Google Scholar 

  13. Fiorentini G, Aliberti C, Turrisi G, Del Conte A, Rossi S, Benea G, Giovanis P (2007) Intra-arterial hepatic chemoembolization of liver metastases from colorectal cancer adopting irinotecan-eluting beads: results of a phase II clinical study. In vivo 21:1085–1092

    PubMed  CAS  Google Scholar 

  14. Golfieri R, Giampalma E, Renzulli M, Galuppi A, Vicenzi L, Galaverni MC, Cappelli A (2006) Unresectable hilar cholangiocarcinoma: multimodality approach with percutaneous treatment associated with radiotherapy and chemotherapy. In vivo 20(6A):757–760

  15. Yonemoto N, Furuse J, Okusaka T, Yamao K, Funakoshi A, Ohkawa S, Boku N, Tanaka K, Nagase M, Saisho H, Sato T (2007) A multi-center retrospective analysis of survival benefits of chemotherapy for unresectable biliary tract cancer. Jpn J Clin Oncol 37(44):843–851

    Google Scholar 

  16. Cantore M, Fiorentini G, Mambrini A, Rabbi C, Zamagni D, Carlone N, Manni A, Caudana R, Torri T (2003) Regional combined with systemic chemotherapy in unresectable biliary tract cancers: a phase II study. J Exp Clin Cancer Res 22(Suppl 4):59–64

    PubMed  CAS  Google Scholar 

  17. Lewis AL, Adams C, Busby W et al (2006) Comparative in vitro evaluation of microspherical embolisation agents. J Mater Sci Mater Med 17:1193–1204

    Article  PubMed  CAS  Google Scholar 

  18. Taylor RR, Tang Y, Gonzales MV et al (2007) Irinotecan drug eluting beads for use in chemoembolization: in vitro and in vivo evaluation of drug release properties. Eur J Pharm Sci 30(1):7–14

    Article  PubMed  CAS  Google Scholar 

  19. Lewis AL, Gonzalez MV, Lloyd AW et al (2006) DC Bead: in vitro characterization of a drug-delivery device for transarterial chemoembolization. J Vasc Interv Radiol 17:335–342

    PubMed  Google Scholar 

  20. Hong K, Khwaja A, Liapi E et al (2006) New intraarterial drug delivery system for the treatment of liver cancer: pre-clinical assessment in a rabbit model of liver cancer. Clin Cancer Res 12:2562–2567

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Camillo Aliberti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aliberti, C., Benea, G., Tilli, M. et al. Chemoembolization (TACE) of Unresectable Intrahepatic Cholangiocarcinoma with Slow-Release Doxorubicin-Eluting Beads: Preliminary Results. Cardiovasc Intervent Radiol 31, 883–888 (2008). https://doi.org/10.1007/s00270-008-9336-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-008-9336-2

Keywords

Navigation