Transcatheter chemoembolization of progressive carcinoid liver metastasis.
OBJECTIVE
The authors report their experience treating progressive liver metastases from carcinoid tumor with doxorubicin, iodized oil, and gelatin sponge embolization.


METHODS
Of 23 patients, 18 had carcinoid syndrome and 19 had elevated urinary 5-hydroxyindoleacetic acid (5-HIAA) levels. Relief of symptoms, changes in 5-HIAA levels, and changes in tumor size could be evaluated in 10, 11, and 17 patients, respectively.


RESULTS
Symptomatic response was complete (average duration, 29 months) in 70% and partial in 30% of evaluated patients. Biologic response was complete (average duration, 21 months) in 73%, partial in 18%, and minor in 9% of evaluated patients. Morphologic response was complete in 11%, partial in 24%, and minor in 24% of evaluated patients. Survival after diagnosis of primary tumor, diagnosis of hepatic metastases, and first chemoembolization was 81, 47, and 24 months, respectively. Eight patients were alive at the end of the study. No mortality was related to chemoembolization.


CONCLUSIONS
Chemoembolization is safe and effective for palliation of carcinoid liver metastases.
Therasse
E
E
Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France.
Breittmayer
F
F
Roche
A
A
De Baere
T
T
Indushekar
S
S
Ducreux
M
M
Lasser
P
P
Elias
D
D
Rougier
P
P
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology / Q000556:secondary* / Q000628:therapy* / Q000652:urine; D002404:Catheterization; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D007269:Injections, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage; D012074:Remission Induction; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology
D008937:Mitomycins; D006897:Hydroxyindoleacetic Acid; D007459:Iodized Oil; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil