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Transarterial embolization combined with octreotide long-acting release in treating rectal neuroendocrine tumor liver
Qing Zhao1, Cui-Xian Li2, Luo-Hai Chen3
1Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
Background:
Liver metastasis is a critical factor of mortality and morbidity in patients with neuroendocrine tumor, and effective management strategies remain a clinical challenge. The treatment regimen of transarterial embolization (TAE) combined with octreotide long-acting release (LAR) for the subgroup of rectal neuroendocrine tumor liver metastases (NETLMs) have not been specially investigated. This study aims to evaluate the efficacy and factors of hepatic progression-free survival (HPFS) and treatment response in patients with rectal NETLMs receiving TAE plus octreotide LAR therapy.
Methods:
This was a retrospective study, which enrolled 84 patients with rectal NETLMs receiving the combination therapy of TAE and octreotide LAR between January 2022 and December 2024. Patients' data were reviewed to evaluate prognostic factors of HPFS and treatment response by the univariate and multivariate Cox proportional hazards models and logistic regression models.
Results:
The median HPFS was 11.1 months. Partial response (PR) in 71 patients (84.5%), stable disease (SD) in 9 patients (10.7%), and progressive disease (PD) in 4 patients (4.8%) were observed. The objective response rate (ORR) was 84.5% in the cohort. In the multivariate Cox regression model, hepatic tumor burden (HTB) ≤25% [hazard ratio (HR) =4.188, P=0.02] was an independent risk factor for HPFS. In the multivariate logistic regression model, tumor border [odds ratio (OR) =0.069, P=0.01] was a positive prognostic factor of treatment response, while 18F-fluorodeoxyglucose-positron emission tomography-computed tomography (18F-FDG PET-CT) (OR =11.919, P=0.003) and Ki-67 (OR =6.469, P=0.018) were negative prognostic factors.
Conclusions:
The therapeutic strategy of TAE combined with octreotide LAR were effective in patients with rectal NETLMs, especially in those with HTB ≤25%. Selected patients with Ki-67 ≤10%, negative 18F-FDG PET-CT and clear tumor border could derive prognostic advantage from the combination treatment.
