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Master Thesis

Les traitements intra-artériels hépatiques multi-lignes chez des patients ayant des métastases hépatiques non opérables de cancer colorectal : expérience d’un CHU

Abstract : Background: fifty percent of colorectal cancer evoluate with limited or predominant liver metastases. Hepatic Intra-Arterial Chemotherapy (HIAC) and chemo-embolization with Irinotecan-loaded micro-beads (DEBIRI) have shown efficacy especially in palliative issues. As far as we know, there was no study that have shown the feasibility of different and successive HIA treatments. We investigated the efficacy and safety of sequential administration of HIA treatments. Methods: we collected efficacy and safety data of all patients who presented non resectable liver metastases of colorectal cancer and who had received at least 2 lines of HIA treatment between March 2010 and June 2016 in our hospital. These data were retrospectively analyzed. The primary objective was the median liver progression free survival. Results: forty one patients were selected. On average, they had received 3.9 previous chemotherapy lines (68% had received more than three lines). Half patients had extra hepatic localization, and 59% had received Oxaliplatin, 37% had received DEBIRI, 5% 5-Fluorouracil (5 FU) and 5% Mitomycin C (MMC) as first line HIA treatment. Second line of CIAH was Oxaliplatin in 14 patients, 5 FU in 15 patients, MMC in 6 patients. Seven patients had received DEBIRI after a previous line of CIAH. These HIA treatments were associated with concurrent chemotherapy in 93% of patients. Adverse events were mostly limited. Liver progression free survival was 7.8 months and overall survival was 17.8 months. Response Rate was 32% (IC 95% [17-46]). Patients treated with DEBIRI after receiving HIAC or HIAC after DEBIRI had a median liver PFS of 9 months and 4.4 months respectively. Conclusion: multiple sequential HIA treatments used after previous systemic chemotherapy are feasible, efficient and present limited toxicity.
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Master Thesis
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Guillaume Velut. Les traitements intra-artériels hépatiques multi-lignes chez des patients ayant des métastases hépatiques non opérables de cancer colorectal : expérience d’un CHU. Médecine humaine et pathologie. 2017. ⟨dumas-01779079⟩

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