Transarterial Chemo and Radioembolization (Yttrium90) of Hepatic Metastasis of Neuroendocrine Tumors: Single Center Experience

Abstract

The aim of this study was to present our single center experience with short (< 3 months) and intermediate-term (> 3 months) follow-up results of patients who underwent transarterial radioembolization with yttrium-90 microsphere (Y-90) or transarterial chemoembolization (TACE) for hepatic metastasis of neuroendocrine tumors (hmNETs). The results of 14 patients treated with either Y-90 or TACE were reviewed retrospectively. Clinical, laboratory, and imaging follow-up was performed. Efficacy was assessed by clinical and morphologic response. Survival was estimated by Kaplan-Meier analysis. Eight patients receiving 12 TACE treatments and 6 patients receiving 7 Y-90 treatments. Response rates were similar with two treatments at short-term follow-up, but there were a lower response rate and higher being progressive disease in the TACE group than Y-90 group at intermediate-term follow-up. However, progression-free survival was lower in Y-90 group (7.5 months) than TACE group (18 months). Regarding our limited experience, both Y-90 treatment and TACE have advantages and disadvantages in treatment of patients with hmNETs, however, randomized controlled studies, are needed.Keywords: Yttrium-90, Chemoembolization, Liver, Neuroendocrine tumors ÖZET Karaci¤er Metastazl› Nöroendokrin Tümörleri olan Hastalara Yap›lan Yttrium-90 Mikroküre (Y-90) ile yap›lan Radyoembolizasyon veya Transarteryel KemoembolizasyonBu çal›flman›n amac› karaci¤er metastazl› nöroendokrin tümörleri olan hastalara yap›lan yttrium-90 mikroküre (Y-90) ile yap›lan radyoembolizasyon veya transarteryel kemoembolizasyon (TAKE) tedavilerinin k›sa (<3 ay) ve orta vadeli (> 3 ay) tek merkez izlem sonuçlar›m›z› tart›flmakt›r. Y-90 veya TAKE ile tedavi edilmifl 14 hastan›n klinik, laboratuar ve bilgisayarl› tomografileri retrospektif olarak de¤erlendirildi. Tedavinin etkinli¤i klinik ve morfolojik yan›t ile de¤erlendirildi. Sa¤kal›m Kaplan-Meier analizi ile hesapland›. Sekiz hastaya 12 TAKE, 6 hastaya 7 Y-90 tedavisi uyguland›. Yan›t oranlar› k›sa vadeli izlemde iki tedavide benzer iken, orta vadede TAKE grubunda Y-90 grubuna göre tedaviye yan›t oran› düflük ve progresyon mevcuttu. Ancak, progresyonsuz sa¤kal›m Y-90 grubunda (7.5 ay) TAKE grubuna (18 ay) göre daha düflüktü. S›n›rl› deneyimlerimize göre, karaci¤er metastazl› nöroendokrin tümörleri olan hastalarda her iki tedavi seçene¤inin de avantaj ve dezavantajlar› olmakla birlikte, randomize kontrollü çal›flmalara ihtiyaç vard›r.