Radioembolization for Unresectable Neuroendocrine Hepatic Metastases Using Resin 90Y-Microspheres: Early Results in 148 Patients

Kennedy, Andrew S.; Dezarn, William A.; McNeillie, Patrick; Coldwell, Doug; Nutting, Charles; Carter, Dennis; Murthy, Ravi; Rose, Steven C.; Warner, Richard R.P.; Liu, David; Palmedo, Holger; Overton, Carroll; Jones, Bonita; Salem, Riad

doi:10.1097/coc.0b013e31815e4557

Cited by 373 publications

(242 citation statements)

References 72 publications

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“…de Baere et al [12] presented an initial review of 20 patients undergoing DEBDOX-based therapy with no mortality and a slightly higher rate of morbidity, but a longer hepatic-specific, progression-free survival time of 15 months. The two largest yttrium-90 reports, from Rhee et al [13] and Kennedy et al [14], again showed minimal morbidity but a vast difference in terms of the median overall survival time. The multi-institutional study from Rhee et al [13] demonstrated a medial overall survival time of 26 months; however, the multi-institutional review from Kennedy et al [14] showed a dramatically longer median overall survival time of 70 months, thus confirming the dramatic heterogeneous nature that some patients present and the wide range in median overall survival times that exists in this patient subset, sometimes regardless of the HAT used.…”

Section: Discussionmentioning

confidence: 99%

“…The two largest yttrium-90 reports, from Rhee et al [13] and Kennedy et al [14], again showed minimal morbidity but a vast difference in terms of the median overall survival time. The multi-institutional study from Rhee et al [13] demonstrated a medial overall survival time of 26 months; however, the multi-institutional review from Kennedy et al [14] showed a dramatically longer median overall survival time of 70 months, thus confirming the dramatic heterogeneous nature that some patients present and the wide range in median overall survival times that exists in this patient subset, sometimes regardless of the HAT used. Bloomston et al [16] presented the single largest series using conventional TACE, demonstrating a median overall survival time similar to that of previous reports, and also finding dramatic improvements in symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Transarterial Chemoembolization and Selective Internal Radiation for the Treatment of Patients with Metastatic Neuroendocrine Tumors: A Comparison of Efficacy and Cost

et al. 2011

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Background. Hepatic arterial therapy (HAT) has been proven to be effective at palliation of hormonal symptoms of metastatic neuroendocrine tumors (NETs), as well as a means of cytoreduction. Recently, the newer modalities of yttrium-90 and drug-eluting beads with doxorubicin (DEBDOX) have been reported to be effective in the treatment of metastatic NETs. The aim of this study was to compare the safety, efficacy, and cost of selective internal radiation with DEB therapy.Methods. An institutional review board-approved, multicenter, multinational prospective treatment registry to investigate the safety and efficacy of yttrium-90 and doxorubicin microspheres was reviewed.Results. In all, 43 patients underwent a combined 69 HAT treatments, with 15 patients receiving 23 yttrium-90 treatments and 28 patients receiving 46 DEB-

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Transarterial Chemoembolization and Selective Internal Radiation for the Treatment of Patients with Metastatic Neuroendocrine Tumors: A Comparison of Efficacy and Cost

et al. 2011

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“…The experience with this technique is still in its infancy, especially in the setting of pNETs. However, early results are encouraging, showing a median survival of approximately 70 months and reporting stable lesions or partial response in 27 and 60.5 % of patients, respectively [79,80].…”

Section: Advanced Diseasementioning

confidence: 99%

Pancreatic Neuroendocrine Tumors: an Update

2015

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Pancreatic neuroendocrine tumors (pNETs) are rare and comprise only 1-2 % of all pancreatic neoplastic disease. Although the majority of these tumors are sporadic (90 %), pNETs can arise in the setting of several different hereditary genetic syndromes, most commonly multiple endocrine neoplasia type 1 (MEN1). The presentation of pNETs varies widely, with over 60 % having malignant distant disease at the time of initial diagnosis involving the liver or other distant sites. Functioning pNETs represent approximately 10 % of all pNETs, secrete a variety of peptide hormones, and are responsible for several clinical syndromes caused by profound hormonal derangement. Surgery remains the cornerstone of therapy and the only curative approach. It should be pursued for localized disease and for metastatic lesions amenable to resection. Multimodality therapies, including liver-directed therapies and medical therapy, are gaining increasing favor in the treatment of advanced pNETs. Their utility is multifold and spans from ameliorating symptoms of hormonal excess (functional pNETs) to controlling the local and systemic disease burden (non-functional pNETs). The recent introduction of target molecular therapy has promising results especially for the treatment of progressive well-differentiated G1/G2 tumor. In this review, we summarize the current knowledge and give an update on recent advancements made in the therapeutic strategies for pNETs.

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“…Radiographic response rates of up to 50% have been achieved in patients with symptomatic or enlarging hepatic tumors. [23][24][25][26] Data are lacking on the long-term results, however, of this form of therapy.…”

Section: Metastatic Diseasementioning

confidence: 99%

Carcinoid and Other Neuroendocrine Tumors of the Colon and Rectum

Eggenberger¹

2011

Clinics in Colon and Rectal Surgery

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Neuroendocrine tumors (NETs) are found throughout the intestinal tract and arise from the Kulchitsky cells located in the crypts of Lieberkühn. They are classified by site of origin and by degree of differentiation, with well-differentiated lesions representing those tumors formerly referred to as carcinoid tumors. The focus of this review is NETs of the appendix, colon, and rectum. The clinical presentation of these tumors is dependent on the primary site and many are discovered incidentally, either during screening or during the investigation of nonspecific abdominal complaints. Treatment is primarily via surgical removal as the response to chemotherapy has been traditionally poor. A noted exception to this has been with treatment of the carcinoid syndrome, which occurs almost exclusively in patients with liver metastases and is due to the release of bioactive peptides and amines directly into the systemic circulation. The use of somatostatin congeners to block the release of these substances has greatly ameliorated the devastating symptoms of this condition. Postresection follow-up is advocated, but specific recommendations are lacking an evidentiary basis. NETS, particularly those of the small bowel, colon, and appendix, are seen in association with other synchronous or metachronous malignancies, often of the gastrointestinal tract. However, the utility of subsequent screening and surveillance is unproven.

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Radioembolization for Unresectable Neuroendocrine Hepatic Metastases Using Resin 90Y-Microspheres: Early Results in 148 Patients

Cited by 373 publications

References 72 publications

Transarterial Chemoembolization and Selective Internal Radiation for the Treatment of Patients with Metastatic Neuroendocrine Tumors: A Comparison of Efficacy and Cost

Transarterial Chemoembolization and Selective Internal Radiation for the Treatment of Patients with Metastatic Neuroendocrine Tumors: A Comparison of Efficacy and Cost

Pancreatic Neuroendocrine Tumors: an Update

Carcinoid and Other Neuroendocrine Tumors of the Colon and Rectum

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