Single-institution experience of radioembolization with yttrium-90 microspheres for unresectable metastatic neuroendocrine liver tumors
Single-institution experience of radioembolization with yttrium-90 microspheres for unresectable metastatic neuroendocrine liver tumors
复制标题
DOI：
10.1111/jgh.13752
复制
发表时间：
2017-09-01
影响因子：
4.1
通讯作者：
Wang, Weiping
中科院分区：
文献类型：
--
作者：
Jia, Zhongzhi;Paz-Fumagalli, Ricardo;Wang, Weiping
Background and Aim: The aim of this study was to assess the effectiveness of yttrium-90 (Y-90) 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 Y-90 therapy for unresectable liver metastases of NET were included and analyzed retrospectively. All patients received a variety of treatments before Y-90 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 Y-90 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.
