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

Abstract

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-

Comparison of Transarterial Liver-Directed Therapies for Low-Grade Metastatic Neuroendocrine Tumors in a Single Institution

“…As such, the longest observation period was seen in patients undergoing HACE, which may account for the favorable TTP. In a 42-patient prospective comparison of SIRT to HACE with DEBOX beads in patients, Whitney et al reported a median PFS of 14 months in patients treated with SIRT which is comparable to our observation 16 .…”

Intra-arterial therapy of neuroendocrine tumour liver metastases: comparing conventional TACE, drug-eluting beads TACE and yttrium-90 radioembolisation as treatment options using a propensity score analysis model

“…However, in a 12-month follow-up, RR in the Y90 group was significantly lower than in the DEB-TACE group. Thus, patients who underwent Y90 were initially salvaged with repeated DEB-TACE treatment, which again underlines the potentially tremendous opportunities of the sequential crossover therapy option [34]. …”

The Efficacy of Hepatic 90Y Resin Radioembolization for Metastatic Neuroendocrine Tumors: A Meta-Analysis

“…It has been suggested that many factors, including prior surgery (33), size of target lesions (34), performance status (35,36), baseline chemistry values (35), Ki-67 index (17), presence of extrahepatic disease (16), and inability to deliver a specified dose (34), influence patient outcomes for treatment of hepatic mNETs with 90 Y radioembolization. Unfortunately, despite publication reporting standards (13), publications do not conform to these standards and such clinical factors are often absent or incomplete, which limited the ability of this meta-analysis to analyze other factors potentially contributing to the pooled results.…”