title: Hepatic arterial chemoembolization using drug-eluting beads in gastrointestinal neuroendocrine tumor metastatic to the liver.
abstract: OBJECTIVE
  This study was designed to evaluate short (<3 months) and intermediate-term (>3 months) follow-up in patients with metastatic neuroendocrine tumor to the liver who underwent hepatic arterial chemoembolization with drug-eluting beads at a single institution.
  
  
  METHODS
  Institutional review board approval was obtained for this retrospective review. All patients who were treated with 100-300 or 300-500 μm drug-eluting LC Beads (Biocompatibles, UK) preloaded with doxorubicin (range, 50-100 mg) for GI neuroendocrine tumor metastatic to the liver from June 2004 to June 2009 were included. CT and MRI were evaluated for progression using Response Evaluation Criteria In Solid Tumors (RECIST) or European Association for the Study of the Liver (EASL) criteria. Short-term (<3 months) and intermediate-term (>3 months) imaging response was determined and Kaplan-Meier survival curves were plotted.
  
  
  RESULTS
  Thirty-eight drug-eluting bead chemoembolization procedures were performed on 32 hepatic lobes, comprising 21 treatment cycles in 18 patients. All procedures were technically successful with two major complications (biliary injuries). At short-term follow-up (<3 months), 22 of 38 (58%) procedures and 10 of 21 (48%) treatment cycles produced an objective response (OR) with the remainder having stable disease (SD). At intermediate-term follow-up (mean, 445 days; range, 163-1247), 17 of 26 (65%) procedures and 8 of 14 (57%) treatment cycles produced an OR. Probability of progressing was approximately 52% at 1 year with a median time to progression of 419 days.
  
  
  CONCLUSIONS
  Drug-eluting bead chemoembolization is a reasonable alternative to hepatic arterial embolization and chemoembolization for the treatment of metastatic neuroendocrine tumor to the liver.
authors: Brigham & Women's Hospital, Angiography and Interventional Radiology, 75 Francis Street, Boston, MA 02115, USA.
authors: Shantanu K
authors: SK
authors: Gaur
authors: Jeremy L
authors: JL
authors: Friese
authors: Cheryl A
authors: CA
authors: Sadow
authors: Rajasekhara
authors: R
authors: Ayyagari
authors: Christoph A
authors: CA
authors: Binkert
authors: Matthew P
authors: MP
authors: Schenker
authors: Matthew
authors: M
authors: Kulke
authors: Richard
authors: R
authors: Baum
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000556:secondary* / Q000628:therapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin