Mina S Makary1, Jordan Kapke2, Vedat Yildiz3, Xueliang Pan3, Joshua D Dowell4. 1. Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. 2. College of Medicine, Columbus, Ohio. 3. Center for Biostatistics, The Ohio State University, Columbus, Ohio. 4. Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH 43210. Electronic address: Joshua.Dowell@OSUMC.edu.
Abstract
PURPOSE: To compare outcomes of conventional transarterial chemoembolization with drug-eluting bead (DEB) chemoembolization for treatment of neuroendocrine tumor liver metastases. MATERIALS AND METHODS: This single-center, retrospective study evaluated 177 transarterial chemoembolization treatments (78 conventional chemoembolization treatments using ethiodized oil-based cisplatin, mitomycin C, and doxorubicin and 99 DEB chemoembolization treatments using doxorubicin-loaded 100-300 μm DEBs) from 2012 to 2015. Hepatic disease distribution was 93% bilobar for both groups with largest lesion size 5.0 cm ± 2.7. No difference was noted in regard to lesion size or distribution, carcinoid syndrome, or pancreastatin production. Clinical outcomes including complications; liver function tests (LFTs); and radiologic (modified Response Evaluation Criteria in Solid Tumors), biochemical (pancreastatin levels), and symptomatic responses were evaluated at 1-month follow-up. RESULTS: Higher symptomatic response (complete and partial) was identified with conventional transarterial chemoembolization compared with DEB chemoembolization (47% vs 30%; P < .05). Patients receiving DEB transarterial chemoembolization experienced lower elevation of LFTs (aspartate aminotransferase, 39 U/L vs 122 U/L; alanine aminotransferase, 20 U/L vs 93 U/L; bilirubin, 0.001 mg/dL vs 0.123 mg/dL; P < .05) and less postembolization syndrome (50% vs 67%; P < .05). Patients undergoing first-time DEB transarterial chemoembolization had lower periprocedural octreotide maximum rate requirements (58 μg/h vs 66 μg/h; P < .05). No difference was observed in biochemical (P = .60) or radiologic (P < .20) responses. CONCLUSIONS: Conventional transarterial chemoembolization yields better symptomatic response and may be preferred for patients experiencing carcinoid symptoms. DEB transarterial chemoembolization, with lower LFT elevations and postembolization syndrome incidence, may be preferred for patients with poor liver function.
PURPOSE: To compare outcomes of conventional transarterial chemoembolization with drug-eluting bead (DEB) chemoembolization for treatment of neuroendocrine tumor liver metastases. MATERIALS AND METHODS: This single-center, retrospective study evaluated 177 transarterial chemoembolization treatments (78 conventional chemoembolization treatments using ethiodized oil-based cisplatin, mitomycin C, and doxorubicin and 99 DEB chemoembolization treatments using doxorubicin-loaded 100-300 μm DEBs) from 2012 to 2015. Hepatic disease distribution was 93% bilobar for both groups with largest lesion size 5.0 cm ± 2.7. No difference was noted in regard to lesion size or distribution, carcinoid syndrome, or pancreastatin production. Clinical outcomes including complications; liver function tests (LFTs); and radiologic (modified Response Evaluation Criteria in Solid Tumors), biochemical (pancreastatin levels), and symptomatic responses were evaluated at 1-month follow-up. RESULTS: Higher symptomatic response (complete and partial) was identified with conventional transarterial chemoembolization compared with DEB chemoembolization (47% vs 30%; P < .05). Patients receiving DEB transarterial chemoembolization experienced lower elevation of LFTs (aspartate aminotransferase, 39 U/L vs 122 U/L; alanine aminotransferase, 20 U/L vs 93 U/L; bilirubin, 0.001 mg/dL vs 0.123 mg/dL; P < .05) and less postembolization syndrome (50% vs 67%; P < .05). Patients undergoing first-time DEB transarterial chemoembolization had lower periprocedural octreotide maximum rate requirements (58 μg/h vs 66 μg/h; P < .05). No difference was observed in biochemical (P = .60) or radiologic (P < .20) responses. CONCLUSIONS: Conventional transarterial chemoembolization yields better symptomatic response and may be preferred for patients experiencing carcinoid symptoms. DEB transarterial chemoembolization, with lower LFT elevations and postembolization syndrome incidence, may be preferred for patients with poor liver function.
Authors: Ron C Gaba; Nasya Mendoza-Elias; Joseph D Morrison; Ali Kord Valeshabad; Andrew J Lipnik Journal: Semin Intervent Radiol Date: 2017-06-01 Impact factor: 1.513
Authors: Jordan M Cloyd; Aslam Ejaz; Bhavana Konda; Mina S Makary; Timothy M Pawlik Journal: Hepatobiliary Surg Nutr Date: 2020-08 Impact factor: 7.293
Authors: Mina S Makary; Stuart Ramsell; Eric Miller; Eliza W Beal; Joshua D Dowell Journal: World J Gastroenterol Date: 2021-11-21 Impact factor: 5.742