Single‐institution experience of radioembolization with yttrium‐90 microspheres for unresectable metastatic neuroendocrine liver tumors. Issue 9 (September 2017)

• Record Type: Journal Article
• Authors: Jia, Zhongzhi; Paz‐Fumagalli, Ricardo; Frey, Gregory; Sella, David M; McKinney, J Mark; Wang, Weiping
• Is Part Of: Journal of gastroenterology and hepatology. Volume 32:Issue 9(2017)
• Page Start: 1617
• Page End: 1623
• Publication Date: 2017-09
• Subjects: liver metastases -- neuroendocrine tumor -- radioembolization -- yttrium‐90; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.13752
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: The aim of this study was to assess the effectiveness of yttrium‐90 ( 90 Y) microspheres for the treatment of unresectable metastatic liver neuroendocrine tumors (NET). Methods: From February 2006 to September 2015, 36 patients (19 male and 17 female, age 63.6 ± 9.4 years) who underwent 90 Y therapy for unresectable liver metastases of NET were included and analyzed retrospectively. All patients received a variety of treatments before 90 Y therapy. The radiological response, symptoms improvement of carcinoid syndrome, tumor marker changes, complications, side effects/toxicity, survival, and factors related to survival were evaluated and analyzed. Results: Of the 36 patients, the mean delivered dose of 90 Y was 1.8 ± 0.7 GBq with a total of 40 treatments. Overall disease control rate was 88.9% (32/36) at 3 months following therapy. In 16 patients with carcinoid syndrome, 15 (93.8%) patients had symptomatic improvement. Tumor marker response (5‐hydroxyindoleacetic acid [ n = 7] and chromogranin A [ n = 13]) at 3 months after treatment were as follows: none ( n = 0, 4), partial ( n = 6, 7), and complete ( n = 1, 2). Radiation‐induced gastrointestinal ulcers ( n = 2, 5.6%) were identified. Side effects included fatigue ( n = 31, 86.1%), anorexia ( n = 26, 72.2%), nausea ( n = 15, 41.7%), vomiting ( n = 14, 38.9%), abdominal pain ( n = 10, 27.8%), and fever ( n = 8, 22.2%). The mean follow‐up was 27.0 ± 16.4 months, with a median survival of 41.0 months. Child–Pugh classification ( P = 0.008) and lymph node metastases ( P = 0.045) had statistically significant influence on overall survival. Conclusions: Yttrium‐90 radioembolization can be effective in the treatment of unresectable liver metastases of NET who failed to respond to other treatments.