title: Transarterial embolization (TAE) is equally effective and slightly safer than transarterial chemoembolization (TACE) to manage liver metastases in neuroendocrine tumors.
abstract: Liver metastases from neuroendocrine tumor (NET) can be treated by transarterial embolization (TAE) or transarterial chemoembolization (TACE). The goal of TAE and TACE is to reduce blood flow to the tumor resulting in tumor ischemia and necrosis. In this retrospective study, the effectiveness and safety of TAE-TACE in the treatment of liver metastases in patients with NET was compared. Thirty patients with a histologically confirmed gastro-entero-pancreatic NET with liver metastases were retrospectively investigated. Seventeen patients underwent TAE, while 13 patients underwent TACE. Tumor response, degree of devascularization in treated lesions, and progression free survival (PFS) were evaluated in the whole population and then separately in TAE and TACE subgroups. In all patients treated with TAE and TACE, there was a significant size reduction of lesions as compared to baseline. Per lesion reduction was 2.2 ± 1.4 versus 3.3 ± 1.5 cm for TAE (p < 0.001) and 2.2 ± 1.5 versus 3.4 ± 1.7 cm for TACE (p < 0.001). In the whole population, the median PFS for all patients was 36 months (16.2-55.7 CI), without significant difference between TAE and TACE. In no patient did adverse events grade 3 and 4 as well as TAE/TACE-related death occurred, while the post-embolization syndrome occurred in 41 % of patients treated with TAE and 61 % of those treated with TACE. TAE and TACE are both effective in NET patients with liver metastases. TAE should be preferred to TACE in light of its similar anti-tumor effects and slightly better toxicity profile.
authors.affiliation: Interventional Radiology, National Cancer Institute, Fondazione "G. Pascale", Naples, Italy, doc.fiore@virgilio.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fiore
authors.forename: Michela
authors.initials: M
authors.lastname: Del Prete
authors.forename: Renato
authors.initials: R
authors.lastname: Franco
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Marotta
authors.forename: Valeria
authors.initials: V
authors.lastname: Ramundo
authors.forename: Francesca
authors.initials: F
authors.lastname: Marciello
authors.forename: Antonella
authors.initials: A
authors.lastname: Di Sarno
authors.forename: Anna Chiara
authors.initials: AC
authors.lastname: Carratù
authors.forename: Chiara
authors.initials: C
authors.lastname: de Luca di Roseto
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.forename: Antongiulio
authors.initials: A
authors.lastname: Faggiano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology* / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult