Brigham & Women's Hospital, Angiography and Interventional Radiology, 75 Francis Street, Boston, MA 02115, USA.
Cardiovasc Intervent Radiol. 2011 Jun;34(3):566-72. doi: 10.1007/s00270-011-0122-1. Epub 2011 Mar 24.
This study was designed to evaluate short (<3 months) and intermediate-term (>3 months) follow-up in patients with metastatic neuroendocrine tumor to the liver who underwent hepatic arterial chemoembolization with drug-eluting beads at a single institution.
Institutional review board approval was obtained for this retrospective review. All patients who were treated with 100-300 or 300-500 μm drug-eluting LC Beads (Biocompatibles, UK) preloaded with doxorubicin (range, 50-100 mg) for GI neuroendocrine tumor metastatic to the liver from June 2004 to June 2009 were included. CT and MRI were evaluated for progression using Response Evaluation Criteria In Solid Tumors (RECIST) or European Association for the Study of the Liver (EASL) criteria. Short-term (<3 months) and intermediate-term (>3 months) imaging response was determined and Kaplan-Meier survival curves were plotted.
Thirty-eight drug-eluting bead chemoembolization procedures were performed on 32 hepatic lobes, comprising 21 treatment cycles in 18 patients. All procedures were technically successful with two major complications (biliary injuries). At short-term follow-up (<3 months), 22 of 38 (58%) procedures and 10 of 21 (48%) treatment cycles produced an objective response (OR) with the remainder having stable disease (SD). At intermediate-term follow-up (mean, 445 days; range, 163-1247), 17 of 26 (65%) procedures and 8 of 14 (57%) treatment cycles produced an OR. Probability of progressing was approximately 52% at 1 year with a median time to progression of 419 days.
Drug-eluting bead chemoembolization is a reasonable alternative to hepatic arterial embolization and chemoembolization for the treatment of metastatic neuroendocrine tumor to the liver.
本研究旨在评估单一机构采用载药微球行肝动脉化疗栓塞术（DEB-TACE）治疗肝转移神经内分泌肿瘤患者的短期（<3 个月）和中期（>3 个月）随访结果。
本回顾性研究获得了机构审查委员会的批准。纳入 2004 年 6 月至 2009 年 6 月期间，因胃肠道神经内分泌肿瘤肝转移而接受载 50-100mg 多柔比星的 100-300μm 或 300-500μm 载药 LC 微球（Biocompatibles，英国）治疗的患者。采用实体瘤反应评价标准（RECIST）或欧洲肝脏研究协会（EASL）标准评价 CT 和 MRI 的进展情况。确定短期（<3 个月）和中期（>3 个月）影像学反应，并绘制 Kaplan-Meier 生存曲线。
32 个肝叶共进行了 38 次载药微球化疗栓塞术，包括 18 例患者的 21 个治疗周期。所有操作均技术成功，仅有 2 例出现严重并发症（胆管损伤）。短期随访（<3 个月）时，38 次操作中的 22 次（58%）和 21 个治疗周期中的 10 个（48%）产生了客观缓解（OR），其余为疾病稳定（SD）。中期随访（平均 445 天，范围 163-1247 天）时，26 次操作中的 17 次（65%）和 14 个治疗周期中的 8 个（57%）产生了 OR。1 年时进展的概率约为 52%，中位无进展时间为 419 天。
载药微球化疗栓塞术是治疗肝转移神经内分泌肿瘤的一种合理选择，可替代肝动脉栓塞化疗。
