• Giovanni Mauri, Gianluca Maria Varano, Paolo Della Vigna, Guido Bonomo, Lorenzo Monfardini, Maria Giulia Zampino, Paola Simona Ravenda, and Franco Orsi.
• Department of Interventional Radiology, European Institute of Oncology, via Ripamonti 435, Milan, Italy. giovanni.mauri@ieo.it.
• Cardiovasc Intervent Radiol. 2018 Nov 1; 41 (11): 1708-1715.

PurposeThis pilot study was performed to investigate safety and local tumor control following transarterial embolization with small-size particles loaded with irinotecan (DEB-IRI) in patients with colorectal liver metastases (CRLM).Materials And MethodsPatients with pretreated CRLM with mono- or bilobar lesions involving less than 60% of the liver parenchyma and Eastern Cooperative Oncology Group performance status 0 or 1 underwent superselective DEB-IRI embolization with 40 µm diameter embolic microspheres.ResultsEighteen patients (11 males, 7 females, median age 61 years) underwent 80 embolization procedures (mean 4.4, range 2-12 per patient). No serious adverse events were reported within 30 days. A total of 39 treatment-related AEs occurred across all embolization procedures. No G4 or G5 treatment-related AEs occurred. Local tumor control, defined as complete response, partial response, or stable disease, was achieved in 16/18 (88.9%), 7/17 (41.2%), and 3/17 (17.6%) patients at 3, 6, and 12 months, respectively. Median liver progression-free survival was 5.9 months (range 27-409 days), and median overall survival was 13.5 months.ConclusionIn this small series, DEB-IRI embolization with small beads was demonstrated a safe procedure in the treatment of patients with CRLM. The promising results in terms of liver-specific progression-free survival and overall survival reported deserve further confirmation in larger prospective trials.Level Of EvidenceLevel 4, case series.

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