Intra-Arterial Chemotherapy in Patients with Liver Metastases from Gastrointestinal Stromal Tumors
https://doi.org/10.37174/2587-7593-2022-5-2-57-63
Abstract
Purpose: To evaluate clinical effectiveness of arterial therapy in patients with gastrointestinal stromal tumors (GIST) metastases to the liver.
Material and methods: Between 2005 and 2021, intra-arterial chemotherapy was performed in 11 patients: 6 men and 5 women aged 40–78 (mean 59) years with immunohistochemically verified liver metastases of GIST. Resection of gastric (n = 4), jejunal (n = 3), sigmoid (n = 1), and pancreatic tumor (n = 1) was performed in 9 patients; tumor of unknown primary origin was in 2 patients. Before intra-arterial treatment, all patients received specific treatment of liver metastases in outside hospitals (liver resection, radiofrequency ablation, tyrosine kinase inhibitors or systemic chemotherapy), but progressed. We performed 56 treatment cycles: oily chemoembolization (n = 37) or its combination with chemoinfusion (n = 19).
Results: According to mRECIST, 1 patient showed complete and 3 partial responses. Stable disease in 4 and progression in 3 patients was seen. Liver resection was carried out in 3 responders. At present, 8 patients died in 28,4 mo (median 32 mo). Three patients are alive for 5–7 years.
Conclusion: Intra-arterial chemotherapy seems to be safe and promising treatment of GIST liver metastases, including patients showing refractory to tyrosine kinase inhibitors.
About the Authors
M. V. Yutkin
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
Russian Federation
Russian Federation
70, Leningradskaya str., Pesochny, St. Petersburg, 197758
A. A. Polikarpov
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
Russian Federation
Russian Federation
70, Leningradskaya str., Pesochny, St. Petersburg, 197758
P. G. Tarazov
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
Russian Federation
Russian Federation
70, Leningradskaya str., Pesochny, St. Petersburg, 197758
I. O. Rutkin
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
Russian Federation
Russian Federation
70, Leningradskaya str., Pesochny, St. Petersburg, 197758
D. A. Granov
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
Russian Federation
Russian Federation
70, Leningradskaya str., Pesochny, St. Petersburg, 197758
References
1. Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis. Am J Surg Pathol. 1983;7(6):507-19. DOI: 10.1097/00000478-198309000-00001.
2. WHO classification of tumours of the digestive system. International agency for research on cancer. Ed by Bosman FT, Carneiro F, Hruban RH, et al. Lyon, 2010; 420 p.
3. Rossi CR, Mocellin S, Mencarelli R, et al. Gastrointestinal stromal tumors: from a surgical to a molecular approach. Int J Cancer. 2003 Nov 1;107(2):171-6. DOI: 10.1002/ijc.11374.
4. DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231(1):51-8. DOI: 10.1097/00000658-200001000-00008.
5. Dematteo RP, Heinrich MC, El-Rifai WM, et al. Clinical management of gastrointestinal stromal tumors: before and after STI-571. Hum Pathol. 2002 May;33(5):466-77. DOI: 10.1053/hupa.2002.124122.
6. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol. 1999 Oct;30(10):1213-20. DOI: 10.1016/s0046-8177(99)90040-0.
7. Clinical guidelines «Gastrointestinal stromal tumors». Association of Oncologists of Russia, 2020, 45 p. (In Russian).
8. Kobayashi K, Gupta S, Trent JC, et. al. Hepatic artery chemoembolization for 110 gastrointestinal stromal tumors: response, survival, and prognostic factors. Cancer. 2006;107(12):2833-41. DOI: 10.1002/cncr.22336.
9. Kobayashi K, Szklaruk J, Trent JC, et. al. Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors. Am J Clin Oncol. 2009;32(6):574-81. DOI: 10.1097/COC.0b013e31819cca35.
10. Takaki H, Litchman T, Covey A, et al. Hepatic artery embolization for liver metastasis of gastrointestinal stromal tumor following imatinib and sunitinib therapy. J Gastrointest Cancer. 2014;45(4):494-9. DOI: 10.1007/s12029-014-9663-2.
11. Cao G, Li J, Shen L, et al. Transcatheter arterial chemoembolization for gastrointestinal stromal tumors with liver metastases. World J Gastroenterol. 2012;18(42):6134-40. DOI: 10.3748/wjg.v18.i42.6134.
12. Rathmann N, Diehl SJ, Dinter D, et al. Radioembolization in patients with progressive gastrointestinal stromal tumor liver metastases undergoing treatment with tyrosine kinase inhibitors. J Vasc Interv Radiol. 2015;26(2):231-8. DOI: 10.1016/j.jvir.2014.09.020.
Review
For citations:
Yutkin M.V., Polikarpov A.A., Tarazov P.G., Rutkin I.O., Granov D.A. Intra-Arterial Chemotherapy in Patients with Liver Metastases from Gastrointestinal Stromal Tumors. Journal of oncology: diagnostic radiology and radiotherapy. 2022;5(2):57-63. (In Russ.) https://doi.org/10.37174/2587-7593-2022-5-2-57-63
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