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Comparative Study
. 2014 Mar;43(2):219-25.
doi: 10.1097/MPA.0000000000000030.

Comparison of transarterial liver-directed therapies for low-grade metastatic neuroendocrine tumors in a single institution

Eric S Engelman  1 , Roberto Leon-Ferre, Boris G Naraev, Nancy Sharma, Shiliang Sun, Thomas M O'Dorisio, James Howe, Anna Button, Gideon Zamba, Thorvardur R Halfdanarson
Affiliations
Comparative Study

Comparison of transarterial liver-directed therapies for low-grade metastatic neuroendocrine tumors in a single institution

Eric S Engelman et al. Pancreas. 2014 Mar.

Abstract

Objective: We compared the clinical outcomes of patients with metastatic neuroendocrine tumors treated with hepatic artery embolization (HAE), chemoembolization (HACE), and selective internal radiation therapy (SIRT) at our institution over the last 10 years.

Methods: The medical records of 42 patients with metastatic neuroendocrine tumors with hepatic metastases treated with HAE, HACE, or SIRT at the University of Iowa from 2001 to 2011 were analyzed.

Results: A total of 13 patients had HAE, 17 patients had HACE, and 12 patients had SIRT as their initial procedure. Time to progression (TTP) was similar between SIRT (15.1 months) and HACE/HAE groups (19.6 months; P = 0.968). There was a trend toward increased TTP in patients receiving HACE (33.4 months) compared with HAE (12.1 months) or SIRT (15.1 months), although not statistically significant (P = 0.512). The overall survival for all patients from the first intervention was 41.9 months. There was no difference between HACE/HAE and SIRT in posttherapy change of chromogranin A (P = 0.233) and pancreastatin (P = 0.158) levels. Time to progression did not correlate with the change in the posttherapy chromogranin A (P = 0.299) or pancreastatin (P = 0.208) levels.

Conclusions: There was no significant difference in TTP in patients treated with SIRT compared with patients treated with HAE or HACE. Baseline and posttherapy marker changes were not predictive of TTP.

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Conflict of interest statement

Conflicts of Interest and Source of Funding Disclosure:

The authors have no conflicts of interest or funding to disclose.

Figures

Figure 1
Figure 1
Symptom response among patients who were symptomatic following their first liver-directed therapy.
Figure 2
Figure 2
Radiographic response at 6-months following their first liver-directed therapy.
Figure 3
Figure 3
Overall time-to-progression after first liver-directed therapy.
Figure 4
Figure 4
Comparison of time-to-progression among SIRT and either HAE or HACE (HA(C)E) following the first liver-directed therapy.
Figure 5
Figure 5
Comparison of time-to-progression among HAE, HACE and SIRT following the first liver-directed therapy.
Figure 6
Figure 6
Overall survival following the first-liver directed therapy.
See this image and copyright information in PMC

References

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