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Evaluation of the Potential of Microspherical Systems for Regional Therapy in the Tumor-Bearing Liver and Kidney Using Techniques in Nuclear Medicine
Published in Neville Willmott, John Daly, Microspheres and Regional Cancer Therapy, 2020
Jacqueline A. Goldberg, James H. McKillop, Colin S. McArdle
In vivo biodegradation was studied in eight patients with advanced metastatic liver disease. The severity of disease was assessed by 99mTc-colloid scan. All patients had previously undergone insertion of a hepatic artery catheter, which had been checked to ensure perfusion of the whole liver and exclude extrahepatic perfusion. HAPS using a tracer dose of commercial 99mTc-albumin microspheres had been performed more than 2 weeks previously and low baseline arteriovenous shunting (<5%) was observed. The patients were started on a regimen of potassium iodate 2 days prior to the administration of 131I-microspheres to prevent uptake of released radioactivity by the thyroid gland. This was continued for 14 days after microsphere administration.
Liver and spleen metastases
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Wolfgang Schima, Helmut Kopf, Claus Kölblinger
The presence of liver metastases is a very common clinical situation in oncological patients. The liver is the most common site of metastatic disease of epithelial tumours, predominantly from the colon, breast, lung, pancreas, and stomach (1). The true prevalence of metastatic liver disease is unknown, but in an autopsy series, liver metastases were detected in up to 70% of cancer patients (1).
Diseases of the Hepatobiliary Tree and Pancreas Associated with Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
After lymph nodes, the liver is the commonest site of secondary tumors. Metastatic liver disease is frequently asymptomatic, yet on occasions may produce a febrile presentation. The fever is usually low grade and may be accompanied by night sweats.182 Other features include right upper quadrant pain, jaundice, ascites, hepatomegaly (often nodular), friction rub, portal hypertension with splenomegaly, and nonspecific symptoms such as anorexia, weakness, and weight loss.182 Unexplained fever due to liver metastases most frequently arises in cases of cancer of the pancreas and gastrointestinal tract,182 breast,183 melanoma,6,182,184 or unknown primary.182 The mechanism of the fever may be tumor necrosis with phagocytic ingestion of debris or release of tumor pyrogen. It is important to exclude an infectious origin of fever,183 such as septicemia or intra-abdominal abscess.185
Tertiary Lymphoid Structures, Immune Response, and Prognostic Relevance in Non-Small Cell Lung Cancer
Published in Cancer Investigation, 2023
Alexandra Giatromanolaki, Paschalis Chatzipantelis, Constantinos A. Contrafouris, Michael I. Koukourakis
TLS often appear in human carcinomas and are more frequently identified in the peritumoral normal tissue, while intratumoral TLS may also exist within the tumor body. Indeed, in our study, one-fourth of tumors did not have TLS in the peritumoral area, while half of the cases did not have TLS in the inner tumor areas. Several studies have focused on the prognostic relevance of TLS in human tumors. In breast cancer, the reports are conflicting. In her-2 positive breast cancer patients, Lee et al. (19) did not find any prognostic relevance, while Sofopoulos et al. (20) found that a high number of TLS in the peritumoral area was linked with poorer disease free and overall survival. However, other studies in breast cancer reported a significant association of TLS with better outcomes (21, 22). In colorectal cancer, TLS abundance seems to be linked with a good prognosis (23). TLS assessed in metastatic liver disease predict for better progression-free survival (24).
Yttrium-90 for colorectal liver metastasis - the promising role of radiation segmentectomy as an alternative local cure
Published in International Journal of Hyperthermia, 2022
Pouya Entezari, Ahmed Gabr, Riad Salem, Robert J. Lewandowski
Most recently, Kurilova et al. evaluated the safety and efficacy of radiation segmentectomy with glass microspheres in patients with limited hepatic metastases [57]. Ten patients with metastatic liver disease deemed not candidates for surgery or thermal ablation, including 2 patients with colorectal origin of metastasis, were included. These patients were treated with ablative tumor targeting (190 Gy), with actual delivered radiation dose to the tumor (MIRD dosimetry) ranging from 163 to 1303 Gy. Based on RECIST 1.1 and Choi criteria, 44 and 100% of patients had partial or complete tumor response, respectively. With a median follow-up of 17.8 months, overall LTP was 21% and the rate of disease progression in the treated segment was 33%. Of two CRLM patients, one had LTP at 4.9 months [57]. The other patient received two treatment sessions and had no tumor progression on the last follow-up visit at 35 months. The one-, two-, and three-year LTP-free survival (LTPFS) was 83, 83, and 69%, respectively, and the median LTPFS was not reached. The median OS was 41.5 months in the entire cohort and three-year OS rate was 74%. Adverse events, reported in 50% of the procedures, were mainly self-limiting. One major complication was observed in a patient with history of prior Whipple surgery who developed biloma and liver abscess 6.5 months after undergoing radiation segmentectomy, requiring hospitalization and abscess aspiration [57].
Thermal ablation versus hepatic resection for the treatment of liver metastases from gastrointestinal stromal tumors: a retrospective study
Published in International Journal of Hyperthermia, 2020
Dao-peng Yang, Bo-wen Zhuang, Yu-zhao Wang, Man-xia Lin, Ming Xu, Ming Kuang, Yang-yang Lei, Xiao-yan Xie, Xiao-hua Xie
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract arising from the interstitial cells of Cajal [1]. Approximately, 20–60% of GIST patients develop liver metastasis [2,3], and metastatic liver disease is a major determinant of patient survival [4]. Tyrosine kinase inhibitors (TKIs) have been regarded as the first-line therapy for metastatic GISTs [5]. Although up to 80% of patients exhibit an initial response to TKI treatment [5], secondary resistance may occur even after years of treatment [6,7]. Several studies have shown that the number of remaining tumor cells might increase the risk of acquiring secondary mutations following TKI treatment [8,9]. This concept has led to various treatment strategies, including surgical resection and thermal ablation. Surgical resection is now widely used in clinical practice for progressive liver metastasis following TKI treatment [10]. The treatment protocol is referenced in current practical guidelines on GIST management [11]. However, tumor multiplicity and the general condition of the patient limit surgical indications. Furthermore, potential complications of surgery may outweigh the theoretical benefit in terms of survival rates.