European Radiology

, Volume 18, Issue 11, pp 2449–2455

Transpulmonary chemoembolization (TPCE) as a treatment for unresectable lung metastases

  • Thomas J. Vogl
  • Thomas Lehnert
  • Stephan Zangos
  • Katrin Eichler
  • Renate Hammerstingl
  • Huedayi Korkusuz
  • Sebastian Lindemayr
Chest

DOI: 10.1007/s00330-008-1056-0

Cite this article as:
Vogl, T.J., Lehnert, T., Zangos, S. et al. Eur Radiol (2008) 18: 2449. doi:10.1007/s00330-008-1056-0

Abstract

To evaluate tumor response after treating unresectable lung metastases with transpulmonary chemoembolization (TPCE) in palliative intention. From 2001 to 2005, 52 patients (mean: 59.8 years; 32 males/20 females) suffering from 106 unresectable lung metastases (mean:6 metastases/patient; range,1–21) were treated with 2–10 TPCE-sessions (mean: 3.3 sessions/patient). Metastases originated from primaries, including colorectal carcinoma (n = 20), breast cancer (n = 6), renal cellular carcinoma (n = 5), thyroid cancer (n = 4), cholangiocellular carcinoma (n = 2), leiomyosarcoma (n = 2), and others (n = 13). Tumor-feeding pulmonary arteries were selectively probed after puncturing the femoral vein, and administering 10 ml lipiodol, mitomycin C, and microspheres (Spherex) each via balloon catheter over pulmonary approach. During therapy, follow-up was accomplished at 4-week intervals using unenhanced and contrast-enhanced CT. After sequential therapy, follow-up was performed every 3 months for a period of 6 months up to 2.25 years. All patients tolerated the treatments well without major side effects or complications. In 24% (n = 13) moderate to high lipiodol uptake was found, while 75% (n = 39) of the tumors showed a low uptake. According to the RECIST criteria, “partial response” was achieved in 16 cases, “stable disease” in 11 cases, and “progressive disease” in 25 cases [mean survival: 17 months/median: 21.1 months (Kaplan-Meyer)]. According to these findings, TPCE is a well-tolerated procedure for palliative treatment of unresectable lung metastases.

Keywords

Chemoembolization Lung metastases Palliative treatment 

Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Thomas J. Vogl
    • 1
  • Thomas Lehnert
    • 1
  • Stephan Zangos
    • 1
  • Katrin Eichler
    • 1
  • Renate Hammerstingl
    • 1
  • Huedayi Korkusuz
    • 1
  • Sebastian Lindemayr
    • 1
  1. 1.Institute of Diagnostic and Interventional RadiologyJohann Wolfgang Goethe-University ClinicFrankfurt am MainGermany

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