Radioembolization for unresectable liver cancer: initial experiences at a single center and review of the literature.

Peynircioğlu, Bora; Çil, Barbaros; Bozkurt, Fani; Aydemir, Ece; Uğur, Ömer; Balkancı, Ferhun

doi:10.4261/1305-3825.dir.2693-09.1

Cited by 18 publications

(16 citation statements)

References 20 publications

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“…4). Decreasing standardized uptake value in high metabolic lesions, as well as the absence of new lesions are considered to indicate good metabolic response and outcome (35). Therefore, we suggest that, imaging methods reflecting metabolic activity like 111 In-octreotide scintigraphy or cellularity like diffusion-weighted MRI can be preferred for the evaluation of liver metastases after radioembolization.…”

Section: Y Microspheres For Neuroendocrine Tumor Liver Metastases • 57mentioning

confidence: 99%

Radioembolization with yttrium-90 resin microspheres for neuroendocrine tumor liver metastases

Peker

Çiçek²,

Soydal³

et al. 2015

Diagn Interv Radiol

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RESULTSThe mean follow-up was 23.0±19.4 months and the median overall survival was 39 months (95% CI, 12.6-65.4 months), with one-and two-year survival rates of 71% and 45%, respectively. Imaging follow-up using RECIST at three-month intervals demonstrated partial response in 43%, complete remission in 3%, stable disease in 37%, and progressive disease in 17% of patients. Extent of tumor involvement was found to have a statistically significant influence on overall survival (P = 0.03). The existence of extrahepatic disease at the time of radioembolization, radiographic response, age, and primary neuroendocrine tumor site were not significant prognostic factors. CONCLUSIONThe current study demonstrates the effectiveness and safety of radioembolization for the treatment of unresectable NETLMs. We identified that the extent of tumor involvement has a significant effect on overall survival. The use of imaging methods reflecting metabolic activity or cellularity such as scintigraphy or diffusion-weighted MRI would be more appropriate, for the response evaluation of liver metastases after radioembolization. N euroendocrine tumors (NETs) are a heterogenous group of slow-growing and hormon-releasing malignant tumors. Even though primary NETs originate from a number of locations, 40%-70% of all carcinoids arise in the small intestine and appendix (1, 2). The most common site for metastasis is the liver. Neuroendocrine tumor liver metastasis (NETLM) results in hormone-secretion-related symptoms leading to carcinoid syndrome, pressure on structures, or liver replacement (1-4). Patients with liver metastasis have a five-year survival rate of less than 20% (5). Over the years, improvements in local treatments yielded better control of the symptoms and survival rates, yet only 10% of the patients have limited illness and are eligible for surgery (6). Patient symptomatology and survival can be improved by transarterial treatments like embolization and chemoembolization (6). Limitations of these techniques include the short duration of the effects and the controversial approaches regarding the optimal timing and sequence of the procedures due to the variability of tumor progression (7,8). Long-term survival benefit was not achieved with systemic chemotherapy (9-11) and treatment with somatostatin analogues is mostly associated with symptomatic relief; there is no clear knowledge of their effect on survival of patients who have carcinoid tumor and metastasis (12).Selective internal radiation therapy (SIRT) has been used to treat unresectable primary and secondary liver cancers for over a decade.

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Section: Y Microspheres For Neuroendocrine Tumor Liver Metastases • 57mentioning

confidence: 99%

Radioembolization with yttrium-90 resin microspheres for neuroendocrine tumor liver metastases

Peker

Çiçek²,

Soydal³

et al. 2015

Diagn Interv Radiol

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“…Technical details are described in the literature. 7 Lobar treatment planning, instead of whole liver treatment at one session was applied in all patients in the study group.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, transarterial liver-directed therapies including TACE, and Y-90 treatments procedure for tumor regression and symptomatic improvement have proven effective in many patients with unresectable and symptomatic NETs hepatic metastases. [7][8][9] In this study, we present our single center experience with short and intermediate-term follow-up results of either Yttrium-90 microspheres (Y-90) or TACE for hepatic neuroendocrine metastases.…”

Section: Introductionmentioning

confidence: 99%

Transarterial Chemo and Radioembolization (Yttrium90) of Hepatic Metastasis of Neuroendocrine Tumors: Single Center Experience

Özkan¹

2013

UHOD

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The aim of this study was to present our single center experience with short (< 3 months) and intermediate-term (> 3 months) follow-up results of patients who underwent transarterial radioembolization with yttrium-90 microsphere (Y-90) or transarterial chemoembolization (TACE) for hepatic metastasis of neuroendocrine tumors (hmNETs). The results of 14 patients treated with either Y-90 or TACE were reviewed retrospectively. Clinical, laboratory, and imaging follow-up was performed. Efficacy was assessed by clinical and morphologic response. Survival was estimated by Kaplan-Meier analysis. Eight patients receiving 12 TACE treatments and 6 patients receiving 7 Y-90 treatments. Response rates were similar with two treatments at short-term follow-up, but there were a lower response rate and higher being progressive disease in the TACE group than Y-90 group at intermediate-term follow-up. However, progression-free survival was lower in Y-90 group (7.5 months) than TACE group (18 months). Regarding our limited experience, both Y-90 treatment and TACE have advantages and disadvantages in treatment of patients with hmNETs, however, randomized controlled studies, are needed.Keywords: Yttrium-90, Chemoembolization, Liver, Neuroendocrine tumors ÖZET Karaci¤er Metastazl› Nöroendokrin Tümörleri olan Hastalara Yap›lan Yttrium-90 Mikroküre (Y-90) ile yap›lan Radyoembolizasyon veya Transarteryel KemoembolizasyonBu çal›flman›n amac› karaci¤er metastazl› nöroendokrin tümörleri olan hastalara yap›lan yttrium-90 mikroküre (Y-90) ile yap›lan radyoembolizasyon veya transarteryel kemoembolizasyon (TAKE) tedavilerinin k›sa (<3 ay) ve orta vadeli (> 3 ay) tek merkez izlem sonuçlar›m›z› tart›flmakt›r. Y-90 veya TAKE ile tedavi edilmifl 14 hastan›n klinik, laboratuar ve bilgisayarl› tomografileri retrospektif olarak de¤erlendirildi. Tedavinin etkinli¤i klinik ve morfolojik yan›t ile de¤erlendirildi. Sa¤kal›m Kaplan-Meier analizi ile hesapland›. Sekiz hastaya 12 TAKE, 6 hastaya 7 Y-90 tedavisi uyguland›. Yan›t oranlar› k›sa vadeli izlemde iki tedavide benzer iken, orta vadede TAKE grubunda Y-90 grubuna göre tedaviye yan›t oran› düflük ve progresyon mevcuttu. Ancak, progresyonsuz sa¤kal›m Y-90 grubunda (7.5 ay) TAKE grubuna (18 ay) göre daha düflüktü. S›n›rl› deneyimlerimize göre, karaci¤er metastazl› nöroendokrin tümörleri olan hastalarda her iki tedavi seçene¤inin de avantaj ve dezavantajlar› olmakla birlikte, randomize kontrollü çal›flmalara ihtiyaç vard›r.

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“…13e15 Prior to radioembolization of HCC, one patient underwent Onyx embolization of the right gastric artery (Fig 5) for the purpose of protecting the gastrointestinal tract. Preembolization is currently recommended 16 as unintended embolization of the gastrointestinal tract can occur during radioembolization due to anastomoses between the right gastric artery and the left hepatic artery. Onyx was selected as the embolization material of choice in each of these cases because of early branching or acute angulation of the vasculature making deployment of microcoils less favourable.…”

Section: Tumour/neoplasmmentioning

confidence: 99%

CT and radiographic appearance of extracranial Onyx® embolization

et al. 2015

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Radioembolization for unresectable liver cancer: initial experiences at a single center and review of the literature.

Cited by 18 publications

References 20 publications

Radioembolization with yttrium-90 resin microspheres for neuroendocrine tumor liver metastases

Radioembolization with yttrium-90 resin microspheres for neuroendocrine tumor liver metastases

Transarterial Chemo and Radioembolization (Yttrium90) of Hepatic Metastasis of Neuroendocrine Tumors: Single Center Experience

CT and radiographic appearance of extracranial Onyx® embolization

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