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Master Thesis

Traitement des métastases hépatiques d’origine colorectale réfractaires à la chimiothérapie systémique, par injection intra-artérielle hépatique de billes chargées à l’Irinotécan (DEBIRI®)

Abstract : Introduction: define oncological effectiveness, OS, toxicity and adverse events (AE) of TACE using DEBIRI® in patients with unreseacable refractory CR-LM. Material and Methods: from September 2012 to November 2014, we included all patients presenting chemo-refractory CRLM from two Universitary Hospitals. Clinical and biological datas were collected. Minor and major AE and toxicity were evaluated according to the WHO classification. We used RECIST criterias for tumor response evaluation. OS and PFS survival were analysed. Results: 36 patients (25 men, 70%), mean age at 66±10 were included. Patients presented tumor lesion number of 1, 2 and >3 in 8%, 28% and 64%. PS was >1 in 22 (61%) patients. CRLM were localised in the right hepatic lobe in 53%, in both hepatic lobes in 36%, disease was synchronous in 67%. 17 (47%) patients had extra-hepatic disease. Patients received 1, 2, 3, 4, 5 cures, respectively in 14%, 36%, 36%, 11%, 3% cases. 47% went under the treatment initialy planned. Significant toxicity was observed in 29 (81%) patients: 29 (70%) pain (level III-WHO pain killers in 12 (33%)), 13 (36%) vomiting. Six patients were lost of sight. Tumoral response was efficient in 7 (23%, 3 complete responses), stable diseased and progressive were respectively in 11 (36%) and 12 (40%) after first evaluation. Mean follow-up was 6 months: PD was observed in 22 (61%) patients and death in 12 (33%A), corresponding to an OS of 16±4 and PFS of 2±0.4 months. Conclusion: tACE with DEBIRI in CRLM is associated with significant toxicity, but this therapeutic alternative leads to oncological control in 2/3 patients and acceptable OS and PFS according to the severity of the initial disease.
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Master Thesis
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Submitted on : Thursday, December 7, 2017 - 3:10:55 PM
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Florence Sattonet. Traitement des métastases hépatiques d’origine colorectale réfractaires à la chimiothérapie systémique, par injection intra-artérielle hépatique de billes chargées à l’Irinotécan (DEBIRI®) . Médecine humaine et pathologie. 2016. ⟨dumas-01658310⟩

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