Chemoembolization for colorectal cancer metastases to the liver – pro
The literature does not contain controlled trials of TACE unresectable hepatic metastases from colon cancer. The outcomes of TACE in the available uncontrolled series appeared similar to outcomes reported of hepatic artery infusion and systemic chemotherapy. The studies do NOT reveal superiority for either TACE or alternatives with respect to complication rates or treatment-related mortality. The outcomes of TACE in the available uncontrolled series appeared similar to outcomes reported of hepatic artery infusion and systemic chemotherapy. The available data also does not show superiority for either TACE or alternatives with respect to complication rates or treatment-related mortality.
AFRQ in 2011 stated: ” Guidelines from the National Comprehensive Cancer Network for metastatic CRC state that ablative therapy for the metastases can be considered when all measurable metastatic disease can in fact be treated. However, the group provides no guidance on which ablative therapy is optimal or on the comparative benefits and harms of the various palliative treatments. A perception of clinical equipoise and limited randomized controlled trial (RCT) data comparing local hepatic therapies31,32 contribute to uncertainty regarding which techniques, either alone or in combination, may be preferable for certain patient groups.”
Hong K, McBride JD, Georgiades CS et al. Salvage therapy for liver-dominant colorectal metastatic adenocarcinoma: comparison between transcatheter arterial chemoembolization versus yttrium-90 radioembolization. J Vasc Interv Radiol 2009; 20(3):360-7. Stuart K, Huberman M, Posner M et al. Chemoembolization for colorectal metastases. Proc Am Soc Clin Oncol 1995; 14:190. Abstract.
Lang EK, Brown CL. Colorectal metastases to the liver: selective chemoembolization. Radiology 1993; 189(2):417-22.
Vogl TJ, Gruber T, Balzer JO et al. Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study. Radiology 2009; 250(1):281-9.
AHRQ – http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=1354&pageaction=displayproduct, 2011
Vogl TJ, Gruber T, Balzer JO et al. Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study. Radiology 2009; 250(1):281-9.