Introduction/Background*CHEMOEMBOLIZATION WITH HepaSphere IN TREATMENT OF PATIENTS WITH PRIMARY AND RECURRENT GYNECOLOGICAL TUMORS

Kedrova A.G. (1), Berishvili A.I. (1), Lebedev D.P. (1), Zvezkina E.A. (1), Krasilnikov C.E. (2)

1 – Federal research and clinical center of specialized kinds of medical care and medical technology FMBA Russia

2 –National medical research center of E.N.Meshalkin

Introduction Primary and recurrent gynecological tumors represent a major challenge because of high risk of bleeding and anemia. The treatment of such patients is always individuals and depends on ECOG status, tumor character (size, location, tumor morphology and biology), clinical symptoms and etc. The transcatheter arterial chemoembolization of the dominate arteries of the tumor (TACE) is a minimal invasive procedure for the blood supply arrest and direct cytotoxic action on the malignant tumor.

Methodology From September 2015 untill February 2020 82 patients were treated with TACE in our clinic: 38 – with recurrent pelvic gynecological tumors and 44 – with locally advanced endometrial and cervical cancer. Morphology: in most (78) cases – adenocarcinoma. In all cases the indication for chemoembolization of tumor supplying arteries was bleeding. The aim of the chemoembolization was to stop bleeding and effect on the tumor with local chemotherapy. Mean age was 44 years. All patients had gynecological examination, ultrasound and MRI/CT with contrast. After arteriography for localization of the tumor suspension of microspheres (HepaSphere, Merit Medical) was injected in tumorsupplying artery. Two flacons (each 25 mg) were saturated with 100mg of Irinotecan or 50 mg of Doxorubicin.

Result(s)*In all cases bleeding control was achieved in one day. At day 7 mean tumor reduction was 24%. Maximal antitumor effect was achieved in 10 days and was kept about 8 weeks. In this period 42 patients were radically operated, 26 – had iv chemotherapy and 14 – chemoradiation. One patient had vesicovaginal fistula as complication that was treated with surgery.

Conclusion*TACE with chemo saturated microspheres (HepaSphere, Merit Medical) is safe minimally invasive and effective method that allows to control vaginal tumor bleeding with cytostatic antitumor effect in patients with primary and recurrent gynecological cancer.