[Efficacy and safety of different sizes drug eluting beads in the treatment of colorectal cancer liver metastasis by TACE].
In a retrospective adult cohort with colorectal cancer liver metastases progressing after first-line therapy, irinotecan-loaded 100–300 μm and 300–500 μm beads used for TACE showed no statistically significant differences in response, survival, or adverse reactions.
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In a retrospective adult cohort with colorectal cancer liver metastases progressing after first-line therapy, irinotecan-loaded 100–300 μm and 300–500 μm beads used for TACE showed no statistically significant differences in response, survival, or adverse reactions.
Research significance
The evidence suggests that both bead-size ranges may provide similar outcomes when DEBIRI-TACE is used as second-line treatment for colorectal liver metastases; it is only an inference—not demonstrated equivalence—that bead size could therefore be selected according to technical or patient-specific considerations, and the record provides no pediatric evidence.
Source abstract
Objective: To compare the efficacy and safety of different-sized drug eluting beads preloaded with irinotrcan (DEBIRI) used in transarterial chemoembolization (TACE) as second-line therapy for colorectal cancer liver metastases (CRC-LM). Methods: A retrospective analysis was conducted on 65 patients with CRC-LM who received TACE at Yantai Yuhuangding Hospital from November 2020 to November 2022. All patients had progressed after first-line therapy. After excluding 5 lost-to-follow-up cases, 30 patients treated with 100-300 μm DEBIRI (small-size group) and 30 patients treated with 300-500 μm microspheres (large-size group) were included. Short- and long-term efficacy and adverse reactions were compared between the two groups. Univariate and multivariate Cox regression analyses were performed to identify factors influencing progression-free survival (PFS) and overall survival (OS). Results: In the small-size group, the objective response rates (ORR) at 1, 3, 6, and 12 months after treatment were 56.7%, 50.0%, 40.0%, and 30.0%, respectively, and the disease control rates (DCR) were 93.3%, 90.0%, 80.0%, and 66.7%, respectively. In the large-size group, the ORR at the same time points were 36.7%, 26.7%, 23.3%, and 16.7%, respectively, and the DCR were 86.7%, 76.7%, 76.7%, and 60.0%, respectively. None of the differences between the two groups were statistically significant (all P＞0.05). The median PFS and OS in the small-size group were 15.0 and 26.0 months, respectively, while in the large-size group they were 13.8 and 21.5 months, respectively, with no statistically significant differences between groups (all P＞0.05). The overall incidence of adverse reactions was 76.6% in the small-size group and 70.0% in the large-size group (P=0.559). The incidence of grade ≥3 adverse reactions was 23.3% and 16.7%, respectively (P=0.519). No treatment-related deaths occurred in either group. Multivariate Cox regression analysis showed that Child-Pugh grade, Eastern Cooperative Oncology Group (ECOG) score, and number of liver metastases were independent influencing factors for both PFS and OS. Conclusion: There was no significant difference in efficacy between 100-300 μm and 300-500 μm drug eluting beads preloaded with irinotrcanused in TACE for the treatment of CRC-LM, and both demonstrated good safety profiles.