View clinical trials related to Liver Metastases.
Filter by:Purpose: The purpose of this study is: to assess and define the current practice of the delivery of irinotecan loaded drug eluting beads in the treatment of liver metastases from colorectal cancer; to correlate how the delivery of this drug compares to worldwide/European guidelines, and to determine which individual variations in delivery may be associated with an increased complication profile or better outcome. The aim of the study is to: 1. Prospectively evaluate the number of centres providing DEBIRI 2. To determine the number of patients being treated nationally per year 3. To evaluate individual variations in practice with respect to number of treatments, method of pain control, side effect profile, and complication profile. 4. To collect patient specific data subsets to allow correlation and causal associations between these individual variations, and relate these to efficacy and survival during the study period.
Colorectal cancer is a major cause of morbidity and mortality throughout the world and accounts for more than 9% of all cancer outcomes. Global mortality from colorectal cancer is approximately half the incidence. An estimated 394,000 colorectal cancer deaths occur worldwide each year, making colorectal cancer the fourth most common cause of cancer death. Overall survival rates after surgical resection of hepatic colorectal metastases were 10-18% higher than in patients treated with systemic therapy. Hepatic metastases occur in 45% of patients with colorectal cancer. Surgery is the standard of care for resectable diseases, with overall survival rates of 5 years (OS) of 28% -58%. Unfortunately, only 10-20% of patients have a resectable disease at the time of diagnosis. The current approach to treating nonresectable metastatic colorectal cancer (mCRC) promotes the use of combined cytotoxic therapy. First-line treatments include cytotoxic combinations. The role of radiotherapy in metastatic cancer is historically palliative, conventional radiotherapeutic techniques causing radiation-induced liver disease (RLID). With the advent of extracranial stereotactic radiotherapy (SBRT), equivalent doses can be safely administered in 3 to 5 fractions, which can result in the removal of all affected tissues in the treated area while limiting the irradiation of the host organ and the healthy tissues surrounding the tumors. The efficacy and safety of SBRT for liver metastases has been confirmed by retrospective studies showing local control rates of about 80% or more. Retrospective studies indicate that approximately 20% of patients remain disease-free 2 to 4 years after SBRT. For patients treated with SBRT, some authors found that half of the patients had no metastatic progression or very little progression in numbers and metastasis sites. These results confirm the idea of an oligometastatic state in which aggressive local therapy could improve progression-free survival (PFS). We propose in this study to evaluate the impact of SBRT on progression-free survival in patients with mCRC with 1-3 oligometastases of the liver. Two arms will be compared: the standard arm treated with chemotherapy; to the experimental arm combining chemotherapy and SBRT. The chemotherapy will be left free at the choice of the investigator according to the recommendations of national treatments.
The primary objective of this study is to correlate the percentage change in apparent diffusion coefficient (ADC) between baseline and early therapy (at day 14) with tumor regression grade (TRG) measured in the surgical resection specimen.
Background: Anatomical (traditional) stereotactic body radio therapy(SBRT) treatment planning assumes homogenous distribution of function in the normal liver tissue. In functional treatment planning, additional information on distribution of the function derived from functional imaging of normal tissue is taken into account. by functional treatment planning it becomes possible to prioritize and spare the best functioning part of an organ. Aim: To test whether functional treatment planning based on 18-FDGal PET/CT may spare the best functioning liver tissue. Endpoints: Reduction in hepatic systemic clearance (K) in the dynamic 18-FDGal PET/CT scan one month after SBRT compared to the baseline status in sub-volumes recieving 15 Gy or higher. Secondly, the investigators will evaluate the toxicity to SBRT by a toxicity scoring system that includes biochemical measures as well as symptomatic scores.