Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma

Abstract

Background: The clinical outcomes of drug-eluting beads transarterial chemoembolization (DEB-TACE) with doxorubicin-loaded CalliSpheres® beads for patients with unresectable or recurrent esophageal carcinoma have not been reported. The aim of this study is to study the clinical outcomes of DEB-TACE for patients with unresectable or recurrent esophageal carcinoma.

Methods: This retrospective study enrolled 21 patients (15 men; mean age 68.7 ± 9.7; range 46-86 years) with unresectable or recurrent esophageal carcinoma received DEB-TACE between July 2017 and September 2020. Patient characteristic data, imaging findings, complications and DEB-TACE procedure were reviewed. The primary endpoints, disease control rate (DCR) and objective response rate (ORR), were calculated. The secondary endpoints were overall survival rate and progression-free survival (PFS).

Results: Twenty-two sessions of DEB-TACE were performed in 21 patients. The technical success rate was 100%; without sever adverse events or procedure-related deaths. All patients received transarterial chemotherapy infusion with raltitrexed or oxaliplatin. The median follow-up period was 3.6 months (interquartile range, IQR 1.5-9.4 months). ORR and DCR were 42.9 and 85.7%, 28.6 and 71.4%, 20.0 and 40.0% respectively at 1-, 3-, and 6-months after DEB-TACE. The median PFS was 6.0 months, and the 3-, 6- and 12-month PFS rates were 68.2%, 45.5 and 0.0%, respectively. The median overall survival was 9.4 months, and the 3-, 6- and 12-month overall survival rates were 75.5%, 55.0 and 13.8%, respectively.

Conclusions: To our knowledge, this is the first study reports outcomes of DEB-TACE with doxorubicin-loaded CallSpheres bead treatment in the management of patients with unresectable or recurrent esophageal carcinoma. According to our results, this is a safe and feasible treatment modality that may be considered among the options for the treatment of these patients.

Keywords: CalliSpheres® beads; Doxorubicin; Drug-eluting beads; Esophageal carcinoma; Transarterial chemoembolization (TACE).

Fig. 1

Images of a 66-year-old man with esophageal cancer in upper and middle esophagus. aBrancheoscopy shows esophageal tumor ingrowths into tracheal wall. bPathological diagnosis of squamous cell carcinoma. cCT scan shows an obvious thickening of esophageal wall and invasion into tracheal wall. dThe right bronchial artery is super-selectively catheterized by a microcatheter. eTumor-feeding artery was embolized using doxorubicin loading-CalliSpheres beads. fAfter 1 month, CT scan shows a stable mass in the esophageal body

Fig. 2

Images of a 75-year-old woman with esophageal cancer in upper and middle esophagus. aBrancheoscopy shows esophageal tumor ingrowths into tracheal wall surrounding the airway stent. bCT scan shows an obvious thickening of esophageal wall and invasion into tracheal wall surrounding the airway stent. dThe right bronchial artery is super-selectively catheterized by a microcatheter. eTumor-feeding artery was embolized using doxorubicin loading-CalliSpheres beads

Fig. 3

Images of a 58-year-old man with esophageal cancer in upper and middle esophagus. aCT scan shows a thickened esophagus with stent in super vein cava. bThe right bronchial artery is the tumor-feeding artery. cThe tumor staining disappeared after DEB-TACE with CalliSpheres beads. dCT scan shows a stable esophageal mass 1 month after DEB-TACE

Fig. 4

Images of an 83-year-old woman with esophageal cancer in upper and middle esophagus. aRadioactive stent was place due to serious stenosis caused by esophageal cancer. bPathological diagnosis of adenocarcinoma. cCT scan shows an obvious thickened esophageal wall with a mass in the right upper lung after 6 months. dThe left gastric artery is super-selectively catheterized and embolized using oxaliplatin loading-CalliSpheres beads. eAfter 9.9 months, CT scan shows a decreased esophageal wall with progressed masses in the right upper lung