Yttrium-90 Radioembolization Versus Transarterial Embolization for Lung Carcinoid Hepatic Metastasis

Area of Science:

• Interventional Radiology
• Oncology
• Hepatobiliary Malignancies

Background:

• Lung carcinoid tumors can metastasize to the liver, necessitating effective treatment strategies.
• Hepatic arterial therapies, including transarterial embolization (TAE) and transarterial radioembolization (TARE), are used to manage these metastases.

Purpose of the Study:

• To compare the safety and efficacy of TARE versus TAE in treating liver metastases from lung carcinoid tumors.

Main Methods:

• Retrospective study of 30 patients with lung carcinoid liver metastasis treated between 2009-2022.
• 53 embolization procedures (24 TARE, 29 TAE) analyzed for local tumor progression-free survival (LTPFS) and overall survival.
• Adverse events assessed using Common Terminology Criteria for Adverse Events v5.0.

Main Results:

• TARE showed significantly improved LTPFS (30.57 months) compared to TAE (13.9 months) (p=0.01).
• Chromogranin A positivity, prior octreotide, and prior everolimus were associated with poorer LTPFS.
• Overall survival did not differ significantly between TARE and TAE (43.5 vs 40.6 months).
• 38% of treatments had adverse events, mostly grade 1-2; severe events were rare.

Conclusions:

• TARE offers superior local tumor control for lung carcinoid liver metastases compared to TAE.
• Both TARE and TAE are safe and effective hepatic arterial therapies for this condition.
• Further research may explore TARE in combination with systemic therapies like everolimus.