In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 4_suppl ( 2012-02-01), p. 300-300
Abstract:
300 Background: There are limited modalities in the treatment of inoperable liver NET metastases. This study compares the efficacy and safety of liver-directed yttrium-90 microspheres, SIR-spheres, to TACE. Methods: Medical records and axial imaging studies were retrospectively reviewed for all patients with NET liver metastases who underwent SIR or doxorubicin based TACE at our institution from Jan 2001 to Dec 2010. The demographics, immediate effects, and time to radiologic progression were assessed and compared between the two treatment modalities. Results: A total of 99 liver directed treatments were performed on 46 pts (n=19 Y-90, n=27 TACE). Median post-treatment follow-up was 20 months (range 4-103). Pt characteristics including age, performance status, type of primary NET, and systemic therapy were similar in both groups. Pts in the SIR group waited longer from the time of metastatic diagnosis to liver-directed therapy (SIR 35 mo vs. TACE 15 mo (p=0.0015)). SIR patients had less liver burden (65% with 〈 25% liver burden) than TACE patients (23% with 〈 25% liver burden). Immediate treatment response (1-3 mo) was measured radiologically using WHO criteria multiplied by EASL criteria. SIR pts achieved 26% complete response (CR), 51% partial response (PR), 15% stable disease (SD), and 8% progressive disease (PR). TACE pts achieved 13% CR, 59% PR, 8% SD, and 21% PD. SIR (44 mo) had a longer radiologic effect than TACE (12 mo) (p=0.015). SIR patients underwent less treatments (95% with 〈 2 treatments) than TACE patients (70% with 〈 2 treatments) (p=0.045). Both treatments were well tolerated with minimal side effects. With only 11/46 (25%) deaths, there was no statistically significant difference in overall survival between the two groups at a median follow up of 104 months (range 12-267). Conclusions: Liver metastasis from NETs can be successfully treated with yttrium-90 radioembolization. Earlier intervention using SIR allows fewer treatments with more durable responses. Prospective studies controlling for rate of disease progression and disease burden are needed to validate these findings.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.4_suppl.300
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
