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Updated: Jul 23, 2025
Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Developments in interventional management of hepatic metastases from neuroendocrine tumours
Ashley Kieran Clift1, Robert Thomas2, Andrea Frilling3
1Cancer Research UK Oxford Centre, University of Oxford, Oxford, United Kingdom; Department of Surgery & Cancer, Imperial College London, London, United Kingdom.
Abstract:
Neuroendocrine tumours commonly metastasise to the liver, particularly those arising from the intestinal tract and pancreas. Whilst surgery offers the only approach with intent to cure, the vast majority of patients with neuroendocrine liver metastases are ineligible. Liver-directed interventional therapies seek to exploit the patho-anatomy of the blood supply of hepatic metastases to deliver therapy to liver deposits. This may involve percutaneous ablation, bland embolization, or the selective infusion of chemotherapeutics, targeted agents or radiolabelled embolic material. Retrospective case series evidence has characterised objective response rates, disease control rates, and longer-term outcomes associated with each approach. Recent advances in this field include ongoing comparative trials of different techniques, but more importantly, combinations of interventional liver-directed therapies and other systemic therapy in multimodal treatment concepts.
Insights
Liver-directed therapies offer treatment options for neuroendocrine tumors that have spread to the liver. These interventional methods target liver deposits, improving outcomes when surgery isn't possible.
Area of Science:
- Oncology
- Interventional Radiology
Background:
- Neuroendocrine tumors frequently metastasize to the liver, especially those originating from the gastrointestinal tract and pancreas.
- Surgical resection is the only curative option, but most patients with neuroendocrine liver metastases are not candidates for surgery.
Purpose of the Study:
- To review liver-directed interventional therapies for neuroendocrine liver metastases.
- To discuss the evidence for objective response rates, disease control, and long-term outcomes of these therapies.
Main Methods:
- Exploitation of the hepatic arterial blood supply to deliver targeted therapies.
- Interventional techniques including percutaneous ablation, bland embolization, and selective infusion of agents (chemotherapeutics, targeted agents, radiolabeled embolic material).
Main Results:
- Retrospective case series have characterized objective response rates, disease control rates, and outcomes.
- Ongoing comparative trials are evaluating different techniques and combinations with systemic therapies.
Conclusions:
- Liver-directed interventional therapies provide valuable treatment options for patients with neuroendocrine liver metastases ineligible for surgery.
- Multimodal treatment concepts combining interventional therapies with systemic treatments are advancing the field.
