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. 2024 Jul;64(7):575-581.
doi: 10.1007/s00117-024-01314-z. Epub 2024 May 18.

[Radiologically guided interventional therapies for the treatment of neuroendocrine tumors]

[Article in German]
C G Radosa  1 , H Nebelung  2 , F Schön  2 , R T Hoffmann  2
Affiliations

[Radiologically guided interventional therapies for the treatment of neuroendocrine tumors]

[Article in German]
C G Radosa et al. Radiologie (Heidelb). 2024 Jul.

Abstract
in English, German

Background: The majority of patients with neuroendocrine tumors (NET) develop liver metastases during the course of the disease, significantly impacting prognosis and quality of life.

Clinical issue: Radiologically guided interventional therapies, such as thermal ablation, transarterial embolization (TAE)/chemoembolization (TACE), and selective internal radiotherapy (TARE), can play a crucial role in the treatment of metastatic NET.

Data: Due to the rarity of the disease, the majority of evidence is based on retrospective studies. For thermal ablation, the complete response rates ranging from 31.6 to 95.3% depending on the study. No significant differences in outcomes were found between TAE, TACE, and TARE. In several studies, all intra-arterial procedures led to a reduction of tumor-related symptoms and achieved disease control.

Conclusion: Thermal ablation can be used as a curative therapy in oligometastatic patients with nonresectable liver metastases from NETs. In cases of disseminated liver metastases, intra-arterial therapy using TAE, TACE, or TARE can be employed.

Zusammenfassung: HINTERGRUND: Die Mehrzahl der Patient*innen mit neuroendokrinen Tumoren (NET) bilden im Verlauf der Krankheit Lebermetastasen aus, welche die Prognose sowie die Lebensqualität deutlich verschlechtern.

Klinisches problem: Radiologisch-interventionelle Therapieverfahren, wie die Thermoablation, die transarterielle Embolisation (TAE)/Chemoembolisation (TACE) und die selektive interne Radiotherapie (transarterielle Radioembolisation, TARE) können somit bei der Behandlung des metastasierten NET eine entscheidende Rolle spielen.

Datenlage: Aufgrund der Seltenheit der Erkrankung basiert der Großteil der Evidenz auf retrospektiven Studien. Für die Thermoablation konnten je nach Studien komplette Ansprechraten von 31,6–95,3 % erreicht werden. Zwischen TAE, TACE und TARE konnte kein signifikanter Unterschied hinsichtlich des Outcomes festgestellt werden. Bei allen intraarteriellen Verfahren konnten in mehreren Studien karzinoidbedingte Symptome verringert und eine Krankheitskontrolle erreicht werden.

Schlussfolgerung: Die Thermoablation kann als kurative Therapie bei oligometastasierten Patienten mit nichtresektablen Lebermetastasen eines NET eingesetzt werden. Bei disseminierten Lebermetastasen kann eine intraarterielle Therapie mittels TAE, TACE oder TARE durchgeführt werden.

Keywords: Ablation; Chemoembolisation; Interventional radiology; Liver metastases; Radioembolisation.

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References

Literatur

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