Transcatheter chemoembolization of progressive carcinoid liver metastasis.

Thérasse, Éric; Breittmayer, F; Roche, Anne; Baere, T. de; Indushekar, S; Ducreux, Michel; Lasser, P; Elias, D; Rougier, P

doi:10.1148/radiology.189.2.7692465

Cited by 163 publications

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“…With a tumour response rate of 37% (CI 95%: 28 -49%), our results are in the range of previous studies regarding treatment's efficacy (Ruszniewski et al, 1993;Therasse et al, 1993;Diaco et al, 1995;Dominguez et al, 2000;Gupta et al, 2003;Kress et al, 2003;O'Toole et al, 2003;Roche et al, 2003). Recently, Roche et al (2004) reported a response rate of 74%, much higher than what we observed.…”

Section: Discussionsupporting

confidence: 82%

“…Post embolisation syndrome was reported only after 47% of procedures in our series, whereas its frequency is usually reported to be higher (Ruszniewski et al, 1993;Therasse et al, 1993;Diaco et al, 1995;Dominguez et al, 2000;Gupta et al, 2003;Kress et al, 2003;O'Toole et al, 2003;Roche et al, 2003Roche et al, , 2004. We can account for this discrepancy by assuming that as this side effect is extremely frequent it was probably not systematically reported, so that we recorded it only when considered significant, that is, responsible for an extension of hospital stay or the use of major analgesics.…”

Section: Discussionmentioning

confidence: 57%

“…Tumour response rate has widely varied between 9 and 60% (Ruszniewski et al, 1993;Therasse et al, 1993;Diaco et al, 1995;Dominguez et al, 2000;Gupta et al, 2003;Kress et al, 2003;O'Toole et al, 2003;Roche et al, 2003Roche et al, , 2004, partly explained by the limited case numbers (most studies involve less than 35 patients) and presumably by some factors related to the patients, their tumours, TACE protocol and previous treatments.…”

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confidence: 99%

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Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

et al. 2006

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Transcatheter arterial chemoembolisation (TACE) has been reported to be an efficient treatment of liver metastases of endocrine tumours in short series of patients. However, several factors seem to affect its results. The aim of this work is to identify predictors of response to TACE for liver metastases of endocrine tumours. A total of 163 TACE procedures were performed in 67 patients between 1994 and 2004. Forty-four patients were treated with streptozotocin and 23 with doxorubicin. Primary tumour was located in the pancreas for 19 patients, and had been removed in 43. Thirty-eight tumours were functioning. Response rate was 37% (confidence interval [CI] 95%: 28 -49%). Median time to progression (TTP) was 14.5 months (CI 95%: 9 -41). In multivariate analysis (n ¼ 43), predictors of tumour response were body mass index (BMI) (odds ratio [OR]: 1.3; CI 95%: 1.04 -1.63; P ¼ 0.022), functioning type of tumour (OR: 7.31; CI 95%: 1.26 -42.5; P ¼ 0.027), arterial phase enhancement on abdominal computed tomography (CT) (OR: 8.11; CI 95%:1.06 -62; P ¼ 0.044) and use of streptozotocin for cytotoxic agent (OR: 21.3; CI 95%: 1.48 -306; P ¼ 0.025). Analysis of TTP predictors showed that BMI (hazard ratio [HR]: 0.85; CI 95%: 0.76 -0.86; P ¼ 0.01) and arterial phase enhancement (HR: 0.3; CI 95%: 0.12 -0.73; P ¼ 0.008) were associated with delayed progression. This large study confirms the previously reported results of TACE regarding its efficacy for the treatment of liver metastases of endocrine tumours. Arterial phase enhancement on abdominal CT and BMI are predictors of treatment's efficacy. Streptozotocin should be the preferred cytotoxic agent in order to save anthracycline for systemic chemotherapy.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 57%

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confidence: 99%

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Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

et al. 2006

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“…Furthermore, the hepatic metastases are angiographically hypervascular, extrahepatic metastases are unusual, and systemic chemotherapy is often ineffective. All of these characteristics have led investigators to attempt both palliative and definitive treatment with chemoembolization [42,80,[85][86][87][88][89][90][91][92][93][94][95].…”

Section: Neuroendocrine Metastasesmentioning

confidence: 99%

Chemoembolization in the Management of Liver Tumors

Stuart

2003

The Oncologist

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The dual vascular supply of the liver affords a unique opportunity to explore intraarterial therapies for hepatic malignancies. Chemoembolization is a well-established technique combining intra-arterial chemotherapy with delivery of embolic agents in order to achieve an antitumor effect due to a high local concentration and prolonged dwell time of the drug, along with select ischemia. Many tumors, such as hepatocellular carcinoma, colorectal cancer, and neuroendocrine tumors, cause symptoms and death by local growth and destruction of the liver.While there are other methods capable of controlling small or isolated hepatic neoplasms, none are suitable for the majority of these patients. Chemoembolization can produce significant results in terms of tumor shrinkage in many of these patients, and there are studies to suggest a survival advantage in hepatocellular carcinoma. Toxicity, however, may be substantial, and patient selection is crucial in order to achieve the optimal benefit of this powerful technique for individual populations. The Oncologist 2003;8:425-437 The Oncologist 2003;8:425-437 www.TheOncologist.com

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“…Carcinoid tumors, although rare, are the most frequent of all endocrine tumors of the gut [1]. The release of a great variety of biologically active hormones and amines directly into the systemic circulation by hepatic metastases causes symptoms of the carcinoid syndrome and severely compromises the patient's lifestyle [2,3].…”

Section: Departmentmentioning

confidence: 99%

Hepatic artery embolotherapy of hepatic metastases from carcinoid tumors: value of using a mixture of cyanoacrylate and ethiodized oil.

Winkelbauer

Niederle²,

Pietschmann³

et al. 1995

American Journal of Roentgenology

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Transcatheter chemoembolization of progressive carcinoid liver metastasis.

Abstract: Chemoembolization is safe and effective for palliation of carcinoid liver metastases.

Cited by 163 publications

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Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

Chemoembolization in the Management of Liver Tumors

Hepatic artery embolotherapy of hepatic metastases from carcinoid tumors: value of using a mixture of cyanoacrylate and ethiodized oil.

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