title: Liver metastases of neuroendocrine tumors: treatment with hepatic transarterial chemotherapy using two therapeutic protocols.
abstract: OBJECTIVE
  The objective of our study was to retrospectively determine the effectiveness of hepatic transarterial chemotherapy using two therapeutic protocols-mitomycin C alone and combined mitomycin C and gemcitabine-on local tumor control and survival rate in patients with liver metastases from neuroendocrine tumors.
  
  
  METHODS
  This article describes a retrospective study of 48 patients (age range, 37-77 years; mean age, 61.1 years; SD, 10.3) with liver metastases from neuroendocrine tumors who underwent repetitive selective hepatic artery chemotherapy using mitomycin C alone (group 1, n = 18 patients who underwent 182 therapeutic sessions; mean, 10.11 sessions per patient) and combined mitomycin C and gemcitabine chemotherapy agents (group 2, n = 30 patients who underwent 312 therapeutic sessions; mean, 10.4 sessions per patient) with 4-week intervals between treatment sessions.
  
  
  RESULTS
  Both treatment protocols were well tolerated by all patients. Only minor side effects occurred in both groups, and no major complications developed. Local tumor control evaluation according to the Response Evaluation Criteria in Solid Tumors (RECIST) revealed the following for group 1: partial response, 11.1%; stable disease, 50%; and progressive disease, 38.9%. RECIST criteria for group 2 indicated partial response in 23.33%, stable disease in 53.34%, and progressive disease in 23.33%. The survival rate from the initial diagnosis to the fifth year for group 1 was 11.11% and for group 2, 46.67%. The median survival time from the initial diagnosis of group 1 was 38.67 months, whereas in group 2 it was 57.1 months.
  
  
  CONCLUSIONS
  Transarterial hepatic chemotherapy using mitomycin C and gemcitabine can be an effective therapeutic protocol for controlling local metastases and improving survival time in patients with hepatic metastases from neuroendocrine tumors.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe University Hospital, Hessen 60590, Germany. t.vogl@em.uni-frankfurt.de
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Tatjana
authors.initials: T
authors.lastname: Gruber
authors.forename: Nagy N N
authors.initials: NN
authors.lastname: Naguib
authors.forename: Renate
authors.initials: R
authors.lastname: Hammerstingl
authors.forename: Nour-Eldin A
authors.initials: NE
authors.lastname: Nour-Eldin
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary*; D012189:Retrospective Studies; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D006490:Hemostatics; D003841:Deoxycytidine; D016685:Mitomycin; D000093542:Gemcitabine