(P138) Yttrium-90 Radioembolization for Liver Metastasis From Neuroendocrine Cancer: A Single-Institution Retrospective Review

OncologyOncology Vol 28 No 1S
Volume 28
Issue 1S

This retrospective analysis concentrates on our institutional experience with transarterial radioembolization (TARE) for the treatment of liver metastasis from neuroendocrine cancer.

Anabel Miguelez, Lorraine Portelance, MD; University of Miami

Purpose: Many publications can be found on the use of yttrium-90 (Y-90) transarterial radioembolization (TARE) for the treatment of primary liver cancer or liver metastasis from colorectal adenocarcinoma. It is important to study the results that could be achieved when TARE is being used to treat liver metastasis of other origin. This retrospective analysis concentrates on our institutional experience with TARE for the treatment of liver metastasis from neuroendocrine cancer.

Materials and Methods: Our institutional review board (IRB)-approved Y-90 databank was reviewed to identify patients with neuroendocrine cancer who received Y-90 TARE for liver metastasis from February 2011 to September 2013. Information on patient demographics, performance status, disease-related characteristics (liver panel, complete blood count [CBC], chromogranin A, and gross tumor volume [GTV] measured in cc on the most recent study pre-TARE), treatment-related parameters (Y-90 dose delivered), and treatment outcome (treatment toxicity, overall survival [OS]) were captured for this analysis.

Results: Between February 2011 and September 2013, a total of 16 patients with metastatic neuroendocrine (liver-predominant disease) received Y-90 TARE in our institution. Eight of these patients received treatment to both liver lobes, for a total of 24 procedures. All patients had an Eastern Cooperative Oncology Group (ECOG) performance status between 0 and 2 prior to treatment. In addition, all patients had a bilirubin level below 2.0 and an albumin level above 3.0 prior to treatment. The median GTV per lobe was 299 cc (range: 27–670 cc). With a median follow-up of 16.5 months (range: 2–26 mo), the 1-year OS was 75%. There was no relationship between OS and GTV volume. Two patients with severe endocrine disorders that required repeated hospitalization (one patient with severe hypoglycemia and a second patient with hypertensive crisis) responded well to TARE, with marked improvement in their medical condition and no need for further admission postprocedure. In terms of treatment toxicity, one patient was diagnosed with a radiation-induced liver disease and died 13 months post-treatment. One patient developed a pancytopenia that was potentially related to treatment.

Conclusion: The use of Y-90 TARE for patients with liver metastasis from neuroendocrine carcinoma is a treatment option that should be assessed in a prospective multicentric study. In this series, Y-90 TARE was associated with a high 1-year survival rate. However, patients need to be monitored closely postprocedure, since serious treatment-related toxicity could develop.

Articles in this issue

(P113) Age and Marital Status Are Associated With Choice of Mastectomy in Patients Eligible for Breast Conservation Therapy
(P112) Single-Institution Experience With Intrabeam IORT for Treatment of Early-Stage Breast Cancer
(P110) Breast Cancer Before Age 40: Current Patterns in Clinical Presentation and Local Management
(P111) Accelerated Partial-Breast Irradiation With Multicatheter High-Dose-Rate Brachytherapy: Feasibility and Results in a Private Practice Cohort
(P115) Breast Cancer Laterality Does Not Influence Overall Survival in a Large Modern Cohort: Implications for Radiation-Related Cardiac Mortality
(P117) Anatomical Variations and Radiation Technique for Breast Cancer
(P116) Bilateral Immediate DIEP Reconstruction and Postmastectomy Radiotherapy: Experience at a Tertiary Care Institution
(P118) Metadherin Overexpression Is Associated With Improved Locoregional Control After Mastectomy
(P119) Effect of Economic Environment on Use of Postlumpectomy Radiation Therapy for Stage I Breast Cancer
(P120) Immediate Versus Delayed Reconstruction After Mastectomy in the United States Medicare Breast Cancer Patient
(P121) Trend in Age and Racial Disparities in the Receipt of Postlumpectomy Radiation Therapy for Stage I Breast Cancer: 2004–2009
(P122) Streamlining Referring Physicians Orders With ‘Reflex Testing’ Significantly Decreases Time to Resolution for Abnormal Screening Mammograms
(P123) National Trends in the Local Management of Early-Stage Paget Disease of the Breast
(P124) Effect of Inhomogeneity on Cardiac and Lung Dose in Partial-Breast Irradiation Using HDR Brachytherapy
(P125) Breast Cancer Outcomes With Anthracycline-Based Chemotherapy for Residual Disease Burden After Full-Dose Neoadjuvant Chemotherapy and Surgery Followed by Radiation Treatment
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