Selective arterial chemoembolization for hepatic metastases from medullary thyroid carcinoma.
BACKGROUND
Hepatic metastases from medullary thyroid carcinoma (MTC) may impair quality of life by hypercalcitonemia-associated diarrhea and pain. In this prospective study, the effect of selective arterial chemoembolization (SACE) was evaluated.


METHODS
Eleven patients with hepatic metastases from MTC received 1 to 9 courses of SACE using epirubicine. Symptomatic, biochemical, and morphologic responses on SACE were recorded.


RESULTS
Symptomatic response was observed in all symptomatic patients. However, biochemical and radiologic response occurred only in 6 patients. Liver function was not affected by SACE. One patient with unexpected concurrent pheochromocytoma metastases died after the first course. Development of side effects in the course was observed in 8 patients but were only World Health Organization grade 1. Patients' satisfaction with SACE was excellent. Long-term follow-up found 7 patients alive (1-72 months). Three patients died with tumor 6, 12, and 24 months after SACE, respectively.


CONCLUSIONS
SACE provided good symptom palliation for the majority of patients with hepatic metastases from MTC. However, transient remission or stabilization of hepatic metastases resulted in only 60%. Further studies using a randomized protocol are required.
Lorenz
Kerstin
K
Department of General, Visceral and Vascular Surgery, Martin-Luther University of Halle-Wittenberg, Germany. kerstin.lorenz@medizin.uni-halle.de
Brauckhoff
Michael
M
Behrmann
Curd
C
Sekulla
Carsten
C
Ukkat
Jörg
J
Brauckhoff
Katrin
K
Gimm
Oliver
O
Dralle
Henning
H
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D018276:Carcinoma, Medullary / Q000556:secondary* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology*; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin