Radioembolization of Symptomatic, Unresectable Neuroendocrine Hepatic Metastases Using Yttrium-90 Microspheres

被引:79
|
作者
Paprottka, Philipp M. [1 ]
Hoffmann, Ralf-T. [1 ]
Haug, Alexander [2 ]
Sommer, Wieland H. [1 ]
Raessler, Franziska [1 ]
Trumm, Christoph G. [1 ]
Schmidt, Gerwin P. [1 ]
Ashoori, Nima [1 ]
Reiser, Maximilian F. [1 ]
Jakobs, Tobias F. [1 ]
机构
[1] Univ Munich, Dept Clin Radiol, D-81377 Munich, Germany
[2] Univ Munich, Dept Nucl Med, D-81377 Munich, Germany
关键词
Radioembolization; Neuroendocrine tumors; Liver metastases; Clinical symptoms; SIRT; LIVER METASTASES; CARCINOID-TUMORS; SURGICAL-TREATMENT; RADIATION-THERAPY; MANAGEMENT; CHEMOEMBOLIZATION; EMBOLIZATION; RESECTION; DIAGNOSIS; BRACHYTHERAPY;
D O I
10.1007/s00270-011-0248-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose To evaluate safety, efficacy, and symptom-control of radioembolization in patients with unresectable liver metastases from neuroendocrine tumors (NETLMs). Materials and Methods Forty-two patients (mean age of 62 years) with treatment-refractory NETLMs underwent radioembolization using yttrium-90 (Y-90) resin microspheres. Posttreatment tumor response was assessed by cross-sectional imaging using the Response Evaluation Criteria in Solid Tumors (RECIST) and tumor-marker levels. Laboratory and clinical toxicities and clinical symptoms were monitored. Results The median activity delivered was 1.63 GBq (range 0.63-2.36). Imaging follow-up using RECIST at 3-month follow-up demonstrated partial response, stable disease, and progressive disease in 22.5, 75.0, and 2.5% of patients, respectively. In 97.5% of patients, the liver lesions appeared hypovascular or partially necrotic. The mean follow-up was 16.2 months with 40 patients (95.2%) remaining alive. The median decrease in tumor-marker levels at 3 months was 54.8% (chromogranin A) and 37.3% (serotonin), respectively. There were no acute or delayed toxicities greater than grade 2 according to Common Terminology Criteria for Adverse Events [CTCAE (v3.0)]. No radiation-induced liver disease was noted. Improvement of clinical symptoms 3 months after treatment was observed in 36 of 38 symptomatic patients. Conclusion Radioembolization with Y-90-microspheres is a safe and effective treatment option in patients with otherwise treatment-refractory NETLMs. Antitumoral effect is supported by good local tumor control, decreased tumor-marker levels, and improved clinical symptoms. Further investigation is warranted to define the role of radioembolization in the treatment paradigm for NETLMs.
引用
收藏
页码:334 / 342
页数:9
相关论文
共 50 条
  • [1] Radioembolization of Symptomatic, Unresectable Neuroendocrine Hepatic Metastases Using Yttrium-90 Microspheres
    Philipp M. Paprottka
    Ralf-T. Hoffmann
    Alexander Haug
    Wieland H. Sommer
    Franziska Raeßler
    Christoph G. Trumm
    Gerwin P. Schmidt
    Nima Ashoori
    Maximilian F. Reiser
    Tobias F. Jakobs
    CardioVascular and Interventional Radiology, 2012, 35 : 334 - 342
  • [2] Radioembolization of Colorectal Hepatic Metastases Using Yttrium-90 Microspheres
    Mulcahy, Mary F.
    Lewandowski, Robert J.
    Ibrahim, Saad M.
    Sato, Kent T.
    Ryu, Robert K.
    Atassi, Bassel
    Newman, Steven
    Talamonti, Mark
    Omary, Reed A.
    Benson, Al, III
    Salem, Riad
    CANCER, 2009, 115 (09) : 1849 - 1858
  • [3] Radioembolization of unresectable hepatic metastases using yttrium-90 microspheres in heavily pretreated colorectal cancer
    Hill, M. E.
    Mulcahy, M. F.
    Lewandowski, R.
    Rademaker, A.
    Salem, R.
    JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (04)
  • [4] Radioembolization with yttrium-90 resin microspheres for neuroendocrine tumor liver metastases
    Peker, Ahmet
    Cicek, Okan
    Soydal, Cigdem
    Kucuk, Nuriye Ozlem
    Bilgic, Sadik
    DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, 2015, 21 (01) : 54 - 59
  • [5] Yttrium-90 radioembolization for unresectable hepatic metastases of breast cancer: A systematic review
    Feretis, Michael
    Solodkyy, Andriy
    WORLD JOURNAL OF GASTROINTESTINAL ONCOLOGY, 2020, 12 (02) : 228 - 236
  • [6] Yttrium-90 radioembolization for unresectable hepatic metastases of breast cancer: A systematic review
    Michael Feretis
    Andriy Solodkyy
    World Journal of Gastrointestinal Oncology, 2020, (02) : 228 - 236
  • [7] Radioembolization with Yttrium-90 microspheres for patients with unresectable hepatocellular carcinoma
    Bhangoo, Munveer Singh
    Karnani, Diraj R.
    Hein, Paul N.
    Giap, Huan
    Knowles, Harry
    Issa, Chris
    Steuterman, Steve
    Pockros, Paul
    Frenette, Catherine
    JOURNAL OF GASTROINTESTINAL ONCOLOGY, 2015, 6 (05) : 469 - 478
  • [8] Radioembolization with yttrium-90 microspheres
    Teichgraeber, U.
    Gebauer, B.
    ONKOLOGE, 2017, 23 (08): : 609 - 618
  • [9] Neuroendocrine Tumor Liver Metastases Treated With Yttrium-90 Radioembolization
    Fan, K. Y.
    Wild, A. T.
    Halappa, V. G.
    Kumar, R.
    Ellsworth, S.
    Pawlik, T. M.
    Cosgrove, D.
    Kamel, I. R.
    Herman, J. M.
    Geschwind, J.
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2013, 87 (02): : S323 - S323
  • [10] Neuroendocrine tumor liver metastases treated with yttrium-90 radioembolization
    Fan, Katherine Y.
    Wild, Aaron T.
    Halappa, Vivek G.
    Kumar, Rachit
    Ellsworth, Susannah
    Ziegler, Mark
    Garg, Tanu
    Rosati, Lauren M.
    Su, Zheng
    Hacker-Prietz, Amy
    Pawlik, Timothy M.
    Cosgrove, David P.
    Hong, Kelvin K.
    Kamel, Ihab R.
    Geschwind, Jean-Francois
    Herman, Joseph M.
    CONTEMPORARY CLINICAL TRIALS, 2016, 50 : 143 - 149