Preview

Tumors of female reproductive system

Advanced search

The role of transarterial chemoembolization with drug-eluting beads “Sphere-Spectrum” in the treatment of primary and recurrent tumors of the female reproductive system complicated by bleeding

https://doi.org/10.17650/1994-4098-2023-19-2-119-126

Abstract

Background. Transarterial chemoembolization (TACE) with drug-eluting beads has been used in the treatment of tumors of the female reproductive system complicated by bleeding. However, questions arise: how to integrate the method into the treatment regimen and at what stage should it be applied?

Aim. To evaluate the effectiveness of TACE in tumors of the female reproductive system complicated by bleeding at different stages of the disease.

Materials and methods. A retrospective analysis of 80 women with primary (group 1) and 20 with recurrent tumors (group 2) of the reproductive system, who underwent 110 TACE with drug-eluting beads “Sphere-Spectrum” (100 primary, 10 repeated), is presented. Mostly used drug-eluting beads “Sphere-Spectrum”. The indication for TACE was tumor bleeding. For dynamic control, magnetic resonance imaging of the small pelvis was performed no later than 14 days before, 14–21 days and 1–3 months after TACE.

Results. Hemostasis after TACE in all cases was achieved by the end of 1 day. There was no progression of the tumor process in any case. In group 1, 56 women (70 %) after TACE were operated on (stages 1B–2A), although according to preoperative magnetic resonance imaging staging, only 34 women (43 %) were subject to surgical treatment; 3 women underwent radiation therapy, 23 – chemoradiotherapy, systemic chemotherapy and immunotherapy in accordance with the stage of the disease. In group 2, 3 women were operated on after correction of their somatic condition and tumor reduction, 3 women underwent chemoradiotherapy, 14 women continued systemic chemotherapy.

Conclusion. TACE has shown high efficiency as a hemostatic and antitumor therapy. It should be included in the treatment regimen for women with bleeding from tumors of the reproductive system at any stage of the disease, which allows expanding the available options for antitumor therapy for this category of patients; at the same time, the use of TACE as a monomethod requires further study.

About the Authors

E. A. Zvezdkina
State Scientific Center for Laser Medicine of Federal Medical and Biology Agency
Russian Federation

Еlena A. Zvezdkina.

40 Studencheskaya St., Moscow 121165


Competing Interests:

None



A. G. Kedrova
Federal Research Clinical Center for Specialized Types of Health Care and Medical Technologies of Federal Medical and Biology Agency of the Russian Federation; Academy of Postgraduate Education, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Medical and Biological Agency of the Russian Federation
Russian Federation

Department of Obstetrics and Gynecology, Academy of Postgraduate Education, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Medical and Biological Agency of the Russian Federation

28 Orekhovyy Bulvar, Moscow 115682; 91 Volokolamskoe Shosse, Moscow 125371


Competing Interests:

None



D. P. Lebedev
Federal Research Clinical Center for Specialized Types of Health Care and Medical Technologies of Federal Medical and Biology Agency of the Russian Federation
Russian Federation

28 Orekhovyy Bulvar, Moscow 115682


Competing Interests:

None



T. A. Greyan
Federal Research Clinical Center for Specialized Types of Health Care and Medical Technologies of Federal Medical and Biology Agency of the Russian Federation
Russian Federation

28 Orekhovyy Bulvar, Moscow 115682


Competing Interests:

None



D. N. Panchenkov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

20/1 Delegatskaya St., Moscow 127473


Competing Interests:

None



Yu. A. Stepanova
A.V. Vishnevsky National Medical Research Center for Surgery, Ministry of Health of Russia
Russian Federation

27 Bolshaya Serpukhovskaya St., Moscow 115093


Competing Interests:

None



S. E. Krasilnikov
Institute of Oncology and Neurosurgery, E.N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation

15 Rechkunovskaya St., Novosibirsk 630055


Competing Interests:

None



K. S. Budennyy
Medical Center, Far Eastern Federal University
Russian Federation

Build. 25, 10 Ayaks Settlement, Russkiy Island, Vladivostok 690922


Competing Interests:

None



References

1. Eleje G., Eke A.C., Igberase G.O. et al. Palliative interventions for controlling vaginal bleeding in advanced cervical cancer. Cochrane Database Syst Rev 2019;3:CD0110002019(3).

2. Рак шейки матки. Клинические рекомендации 2020.

3. Рак тела матки и саркомы матки. Клинические рекомендации 2021.

4. NCCN. Cervical Cancer. Version 1.2021.

5. Bhatla N., Aoki D., Sharma D. et al. Cancer of the cervix uteri: 2021 update. FIGO Cancer Report 2021. DOI: 10.1002/ijgo.13865

6. Koskas M., Amant F., Mirza M. et al. Cancer of the corpus uteri: 2021 update. FIGO Cancer Report 2021. DOI: 10.1002/ijgo.13866.

7. Yanazume S., Karakida N., Higashi R. et al. Tumor bleeding requiring intervention and the correlation with anemia in uterine cervical cancer for definitive radiotherapy. Jpn J Clin Oncol 2018;48(10):892–9. DOI: 10.1093/jjco/hyy113

8. Chen C. S., Park S., Shin J.H. et al. Endovascular treatment for the control of active vaginal bleeding from uterine cervical cancer treated with radiotherapy. Acta Radiol 2018;59(11):1336–42. DOI: 10.1177/0284185118758133

9. Кедрова А.Г., Лебедев Д.П., Астахов Д.А. и др. Применение гепасфер для химиоэмболизации злокачественных опухолей малого таза как этап комплексного лечения. Опухоли женской репродуктивной системы 2018;14(4):35–42.

10. Kennoki N., Saguchi T., Sano T. et al. Long-term histopathologic follow-up of a spherical embolic agent; observation of the transvascular migration of Hepasphere TM. BJR Case Rep 2019;5(1):20180066. DOI: 10.1259/bjrcr.20180066

11. Бабаева Н.А., Ашрафян Л.А., Антонова И.Б. Роль химиоэмболизации маточных артерий в лечении местнораспространенного рака шейки матки: аналитический обзор. Акушерство и гинекология 2017;(1):16–21.

12. Парсян Ш.Г. Оценка эффективности неоадъювантной регионарной химиотерапии при местно-распространеном раке шейки матки. Автореф. дис. … канд. мед. наук. СПб., 2020.

13. Bi Y., Wang Y., Zhang J. et al. Clinical outcomes of uterine arterial chemoembolization with drug-eluting beads for advanced-stage or recurrent cervical cancer. Abdom Radiol 2021; 46:5715–22.

14. Song J., Chen M., Zhu X. et al. Short-term efficacy, safety, and cost-effectiveness of transarterial chemoembolization with drug-eluting beads versus synchronous radiochemotherapy for cervical cancer. Int J Gynaecol Obstet 2019;147(1):29–35. DOI: 10.1002/ijgo.12888


Review

For citations:


Zvezdkina E.A., Kedrova A.G., Lebedev D.P., Greyan T.A., Panchenkov D.N., Stepanova Yu.A., Krasilnikov S.E., Budennyy K.S. The role of transarterial chemoembolization with drug-eluting beads “Sphere-Spectrum” in the treatment of primary and recurrent tumors of the female reproductive system complicated by bleeding. Tumors of female reproductive system. 2023;19(2):119-126. (In Russ.) https://doi.org/10.17650/1994-4098-2023-19-2-119-126

Views: 392


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1994-4098 (Print)
ISSN 1999-8627 (Online)