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Published on: January 25, 2015
Intra-arterial liver-directed therapies for neuroendocrine hepatic metastases
1Department of Diagnostic Radiology, the University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract:
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.
Insights
Transcatheter liver-directed therapies offer effective palliation for neuroendocrine tumor (NET) patients with liver metastases. These treatments provide tumor response and symptom control when surgery or chemotherapy are not options.
Area of Science:
- Oncology
- Interventional Radiology
Background:
- Neuroendocrine tumors (NETs) frequently metastasize to the liver, significantly impacting patient survival and quality of life.
- Surgical resection is limited to a small subset of patients, and systemic chemotherapy often yields poor results.
- While somatostatin analogs manage symptoms, NETs can become refractory to these treatments.
Purpose of the Study:
- To review the technique, safety, and clinical efficacy of transcatheter intra-arterial liver-directed therapies for NETs with hepatic metastases.
- To highlight the role of these therapies in managing refractory, unresectable, or recurrent metastatic disease.
Main Methods:
- Review of transcatheter intra-arterial liver-directed therapies including hepatic artery embolization, chemoembolization, and radioembolization.
- Focus on procedural aspects, safety profiles, and clinical outcomes in patients with metastatic NETs.
Main Results:
- Transcatheter therapies are frequently utilized for unresectable or refractory liver metastases from NETs.
- These interventions demonstrate efficacy in palliating hormonal symptoms associated with NETs.
- Objective tumor responses are achievable with these liver-directed treatments.
Conclusions:
- Hepatic artery embolization, chemoembolization, and radioembolization are valuable treatment modalities for liver metastases from NETs.
- These therapies offer a viable option for symptom control and tumor response in patients unsuitable for surgery.
- Further understanding of technique, safety, and efficacy supports their role in managing advanced NETs.
