Safety and efficacy of transarterial therapies for pancreatic acinar cell carcinoma metastases

经动脉治疗胰腺腺泡细胞癌转移的安全性和有效性

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Abstract

PURPOSE: To evaluate the safety and efficacy of transarterial therapy, including hepatic arterial embolization (HAE) and transarterial radioembolization (TARE), for patients with hepatic metastases secondary to pancreatic acinar cell carcinoma (PACC). METHODS: This retrospective, single-center study included patients with PACC liver metastases treated with transarterial therapy between 11/2013 and 2/2023. Nine patients with PACC were treated in a total of 18 sessions [HAE (n = 14), and TARE (n = 4)]. Patient demographics, tumor characteristics, and radiographic response were recorded. Local tumor progression-free survival (LTPFS) and overall survival (OS) were assessed via Kaplan-Meier analysis. Adverse events were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v5. RESULTS: Median LTPFS was 6.77 months (95 % CI: 3.23-26.33 months) after first treatment. Median assisted LTPFS in the six patients with multiple treatment sessions was 22.33 months (95 % CI: 3.67-31.93 months). Median OS was not reached (95 % CI: 0.17-NR). One-year OS from first treatment was 66.67 % (95 % CI: 28.17-87.83 %). Adverse events within one month of treatment occurred in 5/18 (27.8 %) sessions. Three of the five (60 %) reported complications were grade 1 and included mild post-embolization syndrome. One grade 3 complication occurred; pulmonary embolism associated with hypoxia and treated with anticoagulation. There was one death, grade 5, five days after treatment in a patient with a history of pancreaticoduodenectomy who developed a hepatic abscess complicated by sepsis. CONCLUSION: This small retrospective study suggests that transarterial therapies for PACC provide acceptable local control and safety.

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