Radioembolization with {sup 90}Y Resin Microspheres of Neuroendocrine Liver Metastases: International Multicenter Study on Efficacy and Toxicity

Journal Article · Fri Mar 15 04:00:00 EDT 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-018-2148-0· OSTI ID:22953121

Kappadath, S. C. ^[1]; Ahmadzadehfar, H. ^[2]; Stothers, C. L. ^[3]; Frilling, A. ^[4]; Deroose, C. M. ^[5]; Flamen, P. ^[6]; Brown, D. B. ^[3]; Sze, D. Y. ^[7]; Mahvash, A. ^[8]

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1. University of Texas MD Anderson Cancer Center, Department of Imaging Physics (United States)
2. University Hospital Bonn, Department of Nuclear Medicine (Germany)
3. Vanderbilt University, Department of Radiology and Radiologic Sciences (United States)
4. Imperial College London, Department of Surgery and Cancer (United Kingdom)
5. University Hospital Leuven, Department of Nuclear Medicine (Belgium)
6. Jules Bordet Institute, Department of Nuclear Medicine (Belgium)
7. Stanford University, Department of Interventional Radiology (United States)
8. University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States)

Purpose: Radioembolization of liver metastases of neuroendocrine neoplasms (NEN) has shown promising results; however, the current literature is of limited quality. A large international, multicentre retrospective study was designed to address several shortcomings of the current literature. Materials: 244 NEN patients with different NEN grades were included. Methods: Primary outcome parameters were radiologic response 3 and 6 months after treatment according to RECIST 1.1 and mRECIST. Secondary outcome parameters included clinical response, clinical and biochemical toxicities. Results: Radioembolization resulted in CR in 2%, PR in 14%, SD in 75% and PD 9% according to RECIST 1.1 and in CR in 8%, PR in 35%, SD in 48% and PD in 9% according to mRECIST. Objective response rates improved over time in 20% and 26% according to RECIST 1.1. and mRECIST, respectively. Most common new grade 3–4 biochemical toxicity was lymphocytopenia (6.7%). No unexpected clinical toxicities occurred. Radioembolization-specific complications occurred in < 4%. In symptomatic patients, improvement and resolution of symptoms occurred in 44% and 34%, respectively. Median overall survival from first radioembolization was 3.7, 2.7 and 0.7 years for G1, G2 and G3, respectively. Objective response is independent of NEN grade or primary tumour origin. Significant prognostic factors for survival were NEN grade/Ki67 index, ≥ 75% intrahepatic tumour load, the presence of extrahepatic disease and disease control rate according to RECIST 1.1. Conclusion: Safety and efficacy of radioembolization in NEN patients was confirmed with a high disease control rate of 91% in progressive patients and alleviation of NEN-related symptoms in 79% of symptomatic patients. Level of evidence: 4.

• OSTI ID: 22953121
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 3 Vol. 42; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ENDOCRINE DISEASES
LIVER
METASTASES
MICROSPHERES
NEOPLASMS
PATIENTS
RADIOEMBOLIZATION
RESINS
TOXICITY
YTTRIUM 90