A novel approach to inoperable or recurrent rectal cancer by chemoembolization: A new arrow in our quiver?
OBJECTIVE
Assess the feasibility, safety and efficacy of TACE with irinotecan loaded micro particles (debiri) for the treatment of locally advanced rectal cancer patients.


RESULTS
We assessed the Edmonton Symptom Assessment System (ESAS). The tool is designed to assess nine common symptoms in cancer patients: pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, wellbeing and shortness of breath. The ESAS score was 7 in 10/12 (83%) patients before treatment and 6 in 2/12 (16.5%) patients. After treatment in 6/12 (50%) patients the score dropped to 3; 3/12 (33%) reported 4, 1/12 (8%) reported 2. All patients experienced local control disease with a degree of citoreduction; in 4 cases (33%) we observed outstanding responses with a dramatic reduction in the tumors size which led us to surgical radical resections.


METHODS
We run a prospective mono-institutional study where we recruited, 12 non- consecutive patients with histology confirmation of rectal cancer, inoperable and not treatable due to severe comorbidities, or pelvic recurrence/progression after curative treatment, chemotherapy, radiotherapy and/or surgery. Their performance status (PS) ECOG was 2-3 . Twelve patients (10 male and 2 female) with a median age 71 (range 56-89) were recruited in the study.


CONCLUSIONS
The study has met the primary endpoint and showed encouraging activity. Debiri could be a possible option for locally advanced/inoperable or recurred rectal cancer patients. Further trials are warranted to validate this methodic in early stages.
General Surgery Department, SG Bosco Hospital, Turin, Italy.
Roberto
R
Bini
Interventional Radiology-Neuroradiology Department, SG Bosco Hospital, Turin, Italy.
Simone
S
Comelli
General Surgery Department, SG Bosco Hospital, Turin, Italy.
Renzo
R
Leli
Interventional Radiology-Neuroradiology Department, SG Bosco Hospital, Turin, Italy.
Giacomo Paolo
GP
Vaudano
Interventional Radiology-Neuroradiology Department, SG Bosco Hospital, Turin, Italy.
Daniele
D
Savio
General Surgery Department, SG Bosco Hospital, Turin, Italy.
Tiziana
T
Viora
Oncology Department, Bristol Cancer Center, Bristol, UK.
Alfredo
A
Addeo
D000368:Aged; D000369:Aged, 80 and over; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000401:mortality / Q000628:therapy*
cancer recurrence; chemoembolization; debiri; rectal cancer