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

Autor: Braat AJAT; Department of Radiology and Nuclear Medicine, Imaging Division, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. a.j.a.t.braat@umcutrecht.nl., Kappadath SC; Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Ahmadzadehfar H; Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany., Stothers CL; Department of Radiology and Radiologic Sciences, Vanderbilt University, Nashville, TN, USA., Frilling A; Department of Surgery and Cancer, Imperial College London, London, UK., Deroose CM; Department of Nuclear Medicine, University Hospital Leuven, Louvain, Belgium., Flamen P; Department of Nuclear Medicine, Jules Bordet Institute, Brussels, Belgium., Brown DB; Department of Radiology and Radiologic Sciences, Vanderbilt University, Nashville, TN, USA., Sze DY; Department of Interventional Radiology, Stanford University, Palo Alto, CA, USA., Mahvash A; Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Lam MGEH; Department of Radiology and Nuclear Medicine, Imaging Division, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2019 Mar; Vol. 42 (3), pp. 413-425. Date of Electronic Publication: 2019 Jan 02.
DOI: 10.1007/s00270-018-2148-0
Abstrakt: 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.
Databáze: MEDLINE
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