Intra-Arterial Liver-Directed Therapies for Neuroendocrine Hepatic Metastases
Intra-Arterial Liver-Directed Therapies for Neuroendocrine Hepatic Metastases
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DOI：
10.1055/s-0033-1333651
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发表时间：
2013-03-01
影响因子：
1.4
通讯作者：
Gupta, Sanjay
中科院分区：
文献类型：
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作者：
Gupta, Sanjay
肝转移常见于神经内分泌肿瘤（NETs）患者，对患者的生活质量和生存有重大的不良影响。手术是肝转移的治疗选择，但只有一小部分患者可以手术。全身化疗的结果令人失望。生长抑素类似物对许多此类患者的症状控制有效；然而，这种疾病可能变得难以治疗。经导管肝动脉内定向治疗，如肝动脉栓塞、化疗栓塞和放射栓塞，常用于转移到肝脏的NETs患者，特别是难治性、不可切除性或复发性疾病的患者。这些治疗在缓解激素症状以及实现客观肿瘤反应方面是有效的。本文综述了肝动脉栓塞、化疗栓塞和放射栓塞治疗转移性NETs的技术、安全性和临床疗效。
Hepatic metastases, which are frequently seen in patients with neuroendocrine tumors (NETs), have a major adverse impact on the patient's quality of life and survival. Surgery is the treatment of choice for hepatic metastases but is possible in only a small percentage of patients. Systemic chemotherapy yields disappointing results. Somatostatin analogs are effective in controlling symptoms in many of these patients; however, the disease can become refractory to treatment. Transcatheter intra-arterial liver-directed therapies, such as hepatic artery embolization, chemoembolization, and radioembolization are frequently used in patients with NETs metastatic to the liver, especially in patients with refractory, unresectable, or recurrent disease. These treatments are effective in palliating the hormonal symptoms as well as achieving objective tumor responses. This review focuses on the technique, safety, and clinical efficacy of hepatic artery embolization, chemoembolization, and radioembolization in patients with metastatic NETs.