The role of transcatheter arterial chemoinfusion (TACI) in unresectable adenocarcinoma colorectal:a case report

https://doi.org/10.19106/JMedSci005103201910

Bagaswoto Poedjomartono(1*), P Pramiadi(2)

(1) Departement of Radiology Faculty of Medicine, Universitas Gadjah Mada / Dr. Sardjito General Hospital, Yogyakarta
(2) Departementof Radiology,Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
(*) Corresponding Author

Abstract


Colorectal cancer (CRC) is the fourth most common cancer in worldwide. In the last 10 years, the mortality rate of CRC decreased by more than 20% and 5-year survival remains approximately 60% due to the rising developments in diagnostic techniques and optimization of surgical, neoadjuvant and palliative therapies. We reported a case of 80-year-old woman with diarrhea, blood in the stool and weight loss for a year. The patient was diagnosed with colonic polyp eight years ago. In double-contrast barium enema (DCBE) showed filling defects in sigmoid with pedunculated form. Optical colonoscopy demonstrated tumor in sigmoid. Computed tomography (CT) abdomen showed circumferential thickening and luminal narrowing of sigmoid colon with stranding of the serosa and mesenteric fat as well as enlarge pericolic nodes without distant metastasis. Based on American Joint Committee on Cancer criteria the stage was T3N1M0. From histopathological diagnosis, the tumor was well differentiated adenocarcinoma. We concluded as unresectable adenocarcinoma colorectal. Patient received transcatheter arterial chemoinfusion (TACI) with oxaliplatin and bevacizunab in three courses every 2 months. After first TACI, symptoms and patient’s performance status improved without systemic side effects. Arteriography imaging showed decrease in tumor staining after third TACI. CT evaluation showed a significant decrease of tumor size, without nodal and distant metastasis.In this case, TACI treatment with oxaliplatin and bevacizumab in unresectable adenocarcinoma colorectaldemonstrated improvement of patient’s performance status, partial response, decrease stage and symptoms, without systemic side effects. It is proven that TACI treatment may be an effective palliative therapy for unresectable colorectal cancer. Further studies should be performed to verify these findings.We reported a case of a woman with unresectable adenocarcinoma colorectal showed good results after received TACI treatment.


Keywords


imaging adenocarcinoma colorectal; transcatheter arterial chemoinfusion; unresectable adenocarcinoma colorectal; oxaliplatin; bevacizunab

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References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics 2012. CA Cancer J Clin 2015; 65(2):87-108. http://doi.org/10.3322/caac.21262.
  2. Abdullah M, Sudoyo AW, Utomo AR, Fauzi A, Rani AA. Molecular profile of colorectal cancer in Indonesia : is there another pathway ? Gastroenterol Hepatol Bed Bench 2012; 5(2):71-8.
  3. Sudoyo AW, Lesmana CRA, Krisnuhoni E, Pakasi LS, Cahyadinata L, Lesmana LA. Detection Rate of colorectal adenoma or cancer in unselected colonoscopy patients : Indonesian experience in a private hospital. Asian Pac J Cancer Prev 2014; 15:9801-4.
  4. Kekelidze M, Errico LD, Pansini M, Tyndall A, Hohmann J. Colorectal cancer : current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation. World J Gastroenterol 2013; 19(46):8502-14. http://doi.org/10.3748/wjg.v19.i46.8502.
  5. Schmoll HJ, Van cutsem E, Stein A, Valentini V, Glimelius B, Haustermans K,et al. ESMO Consensus Guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Ann Oncol. 2012; 23(10):2479-516.
  6. Lewandowski RJ, Liapi E, Salem R. Transcatheter intraarterial therapies: rationale and overview. Radiology 2011; 259(3):641-57.
  7. Moghimi-Dehkordi B & Safaee A. An overview of colorectal cancer survival rates and prognosis in Asia. World J Gastrointest Oncol. 2012; 4(4):71-5.
  8. Haggar FA, Boushey RP. Colorectal cancer epidemiology : incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg 2009; 6(212):191-7.
  9. Fernandes GMDM, Leme CVD, Ruiz-Cintra MT, Pavarno EC, Netinho JG, Goloni-Bertollo EMG. Clinical and epidemiological evaluation of patients with sporadic colorectal cancer. J Coloproctol 2014; 34(4):216-23.
  10. Adelstein BA, Macaskill P, Chan SF, Katelaris PH, Irwig L. Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review. BMC Gastroenterol 2011; 11(1):65. http://doi.org/ 10.1186/1471-230X-11-65.
  11. Astin M, Griffin T, Neal RD, Rose P, Hamilton W. The diagnostic value of symptoms for colorectal cancer in primary care : a systematic review. Br J Gen Pr 2011; 61:231-43. http://doi.org/10.3399/bjgp11X572427.
  12. Bullard DKM & Rothenberger DA. Colon, rectum, and anus. In: Brunicardi FC, Andersen DK, Billiar TR, editors. Schwartz’s principles of surgery. 9th ed. Chicago: McGraw-Hill; 2010.
  13. Fearon ER & Vogelstein B. A genetic model for colorectal tumorigenesis. Cell 1990; 61:759-67.
  14. Coura R dos S, Ashton-Prolla P, Prolla JC. Hereditary non-papilomatous colorectal cancer: hereditary predisposisition diagnosis and prevention. Arq Gastroenterol 2005; 42(2):99-106.
  15. Bardhan K, Liu K. Epigenetics and colorectal cancer pathogenesis. Cancers 2013; 5:676-713.
  16. Iyer RB, Silverman PM, Dubrow RA, Charnsangavej C. Imaging in the diagnosis, staging, and follow-up of colorectal cancer. AJR Am J Roentgenol 2002;179:3-13. http://doi.org/10.2214/ajr.179.1.1790003
  17. Edge SB & Compton CC. The American Joint Committee on Cancer:the 7th edition of the AJCC cancer staging manual and the future of TNM.Ann Surg Oncol 2010; 17(6):1471-4. http://doi.org/10.1245/s10434-010-0985-4.
  18. Poston GJ, Tait D, Connell SO. Diagnosis and management of colorectal cancer : summary of NICE guidance. BMJ 2011; 343:d6751:1-5.
  19. Gollub MJ, Schwartz LH, Akhurst T. Update on colorectal cancer imaging. Radiol Clin Nort Am 2007; 45:85-11.
  20. Zoghbi ME &Cummings LC. New era of colorectal cancer screening. World J Gastrointest Endosc 2016; 8(5):252-8.
  21. Chen SC, Lu DSK, Hecht JR, Kadell BM. CT colonography: value of scanning in both the supine and prone positions. AJR Am J Roentgenol 1999; 172:595-9.
  22. Pickhardt PJ. Screening CT colonography : how I do it. AJR Am J Roentgenol 2007;189:290-8.
  23. Pickhardt PJ. Differential diagnosis of polypoid lesions seen at CT colonography (virtual colonoscopy). Radiographics 2004; 24:1535-56.
  24. Heiken JP, Peterson CM, Menias CO. Virtual colonoscopy for colorectal cancer screening: current status. Cancer Imaging 2005; 5:S133-9.
  25. Scalise P, Mantarro A, Pancrazi F, Neri E. Computed tomography colonography for the practicing radiologist: a review of current recommendations on methodology and clinical indications. World J Radiol 2016; 8(5):472-83.
  26. Horton KM, Abrams RA, Fishman EK. Spiral CT of colon cancer : imaging features and role in management. Radiographics 2000; 20:419-30.
  27. Dighe S, Purkayastha S, Swift I, Tekkis PP, Darzi A, A’Hern R, et al. Diagnostic precision of CT in local staging of colon cancers : a meta-analysis. Clin Radiol 2010; 65(9):708-19. http://doi.org/10.1016/j.crad.2010.01.024.
  28. Kaur H, Choi H, You YN. MRI for preoperative evaluation of primary rectal cancer: practical considerations. Radiographics 2012; 32:389-409.
  29. Tatl S, Tapan Ü, Özbayrak M. MRI in local staging of rectal cancer: an update. Diagn Interv Radiol 2014; 20:390-8.
  30. van Cutsem E, Verheul HM, Flamen P, Rougier P, Beets-Tan R, Glynne-Jones R, et al. Imaging in colorectal cancer: progress and challenges for the clinicians. Cancers 2016; 8(81):1-14. http://doi.org/10.3390/cancers8090081.
  31. Eisenhauer EA, Therasse P, Bogaerts J, Schwatz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours : revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45(2):228-47. http://doi.org/10.1016/j.ejca.2008.10.026.
  32. Marcus C, Xiao J, Subramaniam RM. FDG PET/CT in the management of colorectal and Anal cancers. AJR Am J Roentgenol 2014; 203:1109-19.
  33. Collins JM. Pharmacologic rationale for regional drug delivery. J Clin Oncol 1984; 2(5):498-504.
  34. Arteaga CL, Baselga J. Clinical trial design and end points for epidermal growth factor receptor-targeted therapies: implications for drug development and practice. Clin Cancer Res. 2003; 9(5):1579-89.
  35. Austoker J. Cancer prevention in primary care screening for colorectal cancer. BMJ 1994; 309:382-6.
  36. Fleming M, Ravula S, Tatishchev SF, Wang HL. Colorectal carcinoma : pathologic aspects. J Gastrointest Oncol 2012; 3(3):153-73. http://doi.org/10.3978/j.issn.2078-6891.2012.030.



DOI: https://doi.org/10.19106/JMedSci005103201910

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