title: Radiofrequency Ablation Combined with Hepatic Arterial Chemoembolization Using Degradable Starch Microsphere Mixed with Mitomycin C for the Treatment of Liver Metastasis from Colorectal Cancer: A Prospective Multicenter Study.
abstract: OBJECTIVE
  This phase II prospective study investigates possible benefits of radiofrequency ablation (RFA) combined with hepatic arterial chemoembolization using degradable starch microsphere (DSM) mixed with mitomycin C (MMC) in non-surgical candidates with colorectal liver metastases.
  
  
  METHODS
  This study, approved by the respective institutional review board, included non-surgical candidates with 3 or fewer liver tumors of 3 cm or smaller, or a single lesion 5 cm or smaller. Percutaneous RFA was performed immediately after chemoembolization using DSM-MMC. Primary and secondary endpoints were the local tumor control rate, safety, and 2-year recurrence-free and overall survival rates.
  
  
  RESULTS
  This study examined 25 patients (22 males, 3 females) with 38 tumors of mean maximum diameter of 2.2 ± 0.9 cm (standard deviation) (range 1.0-4.2 cm). Their mean age was 70.2 ± 8.2 years (range 55-82 years). Local tumor progression developed in 3 tumors (7.9%, 3/38) of 3 patients (12%, 3/25) during the mean follow-up of 34.9 ± 9.2 months (range 18.3-50.1 months). The 2-year local tumor control rates were 92.0% [95% confidence interval (CI), 81.4-100%] on a patient basis and 94.6% (95% CI, 87.3-100%) on a tumor basis. The respective 2-year overall and recurrence-free survival rates were 88.0% (95% CI, 75.3-98.5%) and 63.3% (95% CI, 44.2-82.5%), with median survival time of 48.4 months. Fever was the only adverse event requiring treatments in 2 patients (8%).
  
  
  CONCLUSIONS
  This combination therapy is safe, exhibiting strong anticancer effects on colorectal liver metastasis, which might contribute to patient survival.
authors.affiliation: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan. yamakado47@gmail.com.|Department of Radiology, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. yamakado47@gmail.com.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.affiliation: Department of Radiology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Inaba
authors.affiliation: Department of Radiology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Yozo
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Radiology, Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Yasumoto
authors.affiliation: Department of Radiology, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
authors.forename: Sadao
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Department of Radiology, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamanaka
authors.affiliation: Department of Radiology, Kouseiren Takaoka Hospital, 4-1 Takaramachi, Takaoka, Toyama, 933-8550, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Nobata
authors.affiliation: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.|Department of Radiology, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Takaki
authors.affiliation: Department of Radiology, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Nakatsuka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D016609:Neoplasms, Second Primary / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D013213:Starch / Q000008:administration & dosage*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: C083286:degradable starch microspheres; D016685:Mitomycin; D013213:Starch
keywords: Chemoembolization; Colorectal cancer; Liver metastasis; Local recurrence; Radiofrequency ablation