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 ((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 (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.
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 ((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 (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.
Authors: K J Paprottka; F Schoeppe; M Ingrisch; J Rübenthaler; N N Sommer; E De Toni; H Ilhan; M Zacherl; A Todica; P M Paprottka Journal: Eur J Nucl Med Mol Imaging Date: 2017-02-14 Impact factor: 9.236
Authors: Wieland H Sommer; Felix Ceelen; Xabier García-Albéniz; Philipp M Paprottka; Christoph J Auernhammer; Marco Armbruster; Konstantin Nikolaou; Alexander R Haug; Maximilian F Reiser; Daniel Theisen Journal: Eur Radiol Date: 2013-06-28 Impact factor: 5.315
Authors: Nicholas Fidelman; Robert K Kerlan; Randall A Hawkins; Miguel Pampaloni; Andrew G Taylor; Maureen P Kohi; K Pallav Kolli; Chloe E Atreya; Emily K Bergsland; R Kate Kelley; Andrew H Ko; W Michael Korn; Katherine Van Loon; Ryan M McWhirter; Jennifer Luan; Curt Johanson; Alan P Venook Journal: J Gastrointest Oncol Date: 2016-12
Authors: Rahul Mehta; Kejia Cai; Nishant Kumar; M Grace Knuttinen; Thomas M Anderson; Hui Lu; Yang Lu Journal: Technol Cancer Res Treat Date: 2016-09-06
Authors: Nicholas Fidelman; Robert K Kerlan; Randall A Hawkins; Andrew G Taylor; Maureen P Kohi; K Pallav Kolli; Emily K Bergsland; R Kate Kelley; Andrew H Ko; W Michael Korn; Ryan M McWhirter; Jennifer Luan; Alan P Venook Journal: J Gastrointest Cancer Date: 2014-06