Drug-eluting bead transarterial chemoembolization in the treatment for unresectable soft tissue sarcoma refractory to systemic chemotherapy: a preliminary evaluation of efficacy and safety

Abstract

Purpose: To preliminarily evaluate the clinical efficacy and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE) for unresectable soft tissue sarcoma refractory to systemic chemotherapy.

Methods: Ten patients with refractory sarcoma who underwent DEB-TACE therapy between January 2015 and January 2017 were identified. Clinical information and radiological data were retrospectively collected to analyze tumor response, overall survival (OS), progression-free survival and adverse events (AEs). Tumor response to DEB-TACE was assessed with modified Response Evaluation Criteria in Solid Tumors (mRECIST) guidelines applied to computed tomography or magnetic resonance imaging.

Results: All DEB-TACE procedures were successfully performed for ten patients with 15 tumor lesions. The median follow-up duration was 19 months and the median survival time was 21 months (range 11-30 months). The 1- and 2-year OS rate was 90 and 30%, respectively. According to the guidance of mRECIST, complete response, partial response, stable disease and progressive disease were noted in zero (0%), three (30%), four (40%) and three (30%) patients, respectively. The disease control rate and objective response rate was 70 and 30%, respectively. There were no serious AEs in patients after DEB-TACE.

Conclusions: Our data showed that DEB-TACE was effective and safe for patients with soft tissue sarcoma. Therefore, DEB-TACE can be considered as an alternative treatment option for unresectable soft tissue sarcoma refractory to conventionally systemic chemotherapy.

Keywords: Drug-eluting bead; Soft tissue sarcoma; Systemic chemotherapy; Transarterial chemoembolization.

Fig. 1

Kaplan–Meier curve shows overall survival rates for patients who underwent drug-eluting bead transarterial chemoembolization (DEB-TACE) treatment

Fig. 2

Kaplan–Meier curve shows progression-free survival rates for patients who underwent drug-eluting bead transarterial chemoembolization (DEB-TACE) treatment

Fig. 3

Representative pictures of pre-DEB-TACE (a, b) and post-DEB-TACE (f) CT scans and pre-DEB-TACE (d) and post-DEB-TACE (e) angiographies of a 38-year-old female patient with histologically established (c) synovial sarcoma. Post-DEB-TACE images (e, f) show reduced tumor staining and tumor size. (a is non contrast-enhanced CT scan which shows the pathological calcification inside the rumor lesion. DEB-TACE drug-eluting bead transarterial chemoembolization)