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

Journal Article · Sun Apr 15 00:00:00 EDT 2012 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-011-0248-1· OSTI ID:21608552

Hoffmann, Ralf-T ^[1]; Haug, Alexander ^[2]; Sommer, Wieland H; Raessler, Franziska; Trumm, Christoph G; Schmidt, Gerwin P; Ashoori, Nima; Reiser, Maximilian F; Jakobs, Tobias F ^[1]

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1. Ludwig-Maximilians-University of Munich, Department of Clinical Radiology (Germany)
2. Ludwig-Maximilians-University of Munich, Department of Nuclear Medicine (Germany)

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 ({sup 90}Y) 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 {sup 90}Y-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.

• OSTI ID: 21608552
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 35, Issue 2; Other Information: DOI: 10.1007/s00270-011-0248-1; Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CONTROL
EVALUATION
LIVER
MATERIALS
METASTASES
MICROSPHERES
NEOPLASMS
PATIENTS
RESINS
SAFETY
SEROTONIN
SYMPTOMS
TOXICITY
YTTRIUM 90
AMINES
AROMATICS
AUTONOMIC NERVOUS SYSTEM AGENTS
AZAARENES
AZOLES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
DAYS LIVING RADIOISOTOPES
DIGESTIVE SYSTEM
DISEASES
DRUGS
GLANDS
HETEROCYCLIC COMPOUNDS
HOURS LIVING RADIOISOTOPES
HYDROXY COMPOUNDS
INDOLES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NEUROREGULATORS
NUCLEI
ODD-ODD NUCLEI
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANIC POLYMERS
ORGANS
PETROCHEMICALS
PETROLEUM PRODUCTS
POLYMERS
PYRROLES
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
RESPONSE MODIFYING FACTORS
SYMPATHOMIMETICS
TRYPTAMINES
YTTRIUM ISOTOPES