Transarterial radioembolization in neuroendocrine liver metastases 25 years later: A systematic review

Transarterial Radioembolization (TARE) currently lacks a defined role in treating neuroendocrine liver metastases (NELM). This systematic review aims to clarify TARE's role based on its prognostic impact. A search identified 138 studies onPubMed/MEDLINE over the past 25 years, focusing on TARE for NELM patients. Of these, 46 studies met eligibility criteria, and 11 were selected for their similar settings, populations, and outcomes. These were grouped into three clusters based on survival outcomes: overall survival (OS), hepatic progression-free survival (HPFS), and imaging response (IR) per RECIST 1.1 criteria. Statistical analyses showed a median OS of 33 months for 809 patients, a median HPFS of 24 months for 414 patients, and an IR of 28.6 % complete or partial response, 57.8 % stable disease, and 13.6 % disease progression in 581 patients. This evidence supports TARE as a viable treatment option, but further studies are needed to optimize its use and dosimetric procedures.