title: Comparison of transarterial liver-directed therapies for low-grade metastatic neuroendocrine tumors in a single institution.
abstract: OBJECTIVE
  We compared the clinical outcomes of patients with metastatic neuroendocrine tumors treated with hepatic artery embolization (HAE), chemoembolization (HACE), and selective internal radiation therapy (SIRT) at our institution over the last 10 years.
  
  
  METHODS
  The medical records of 42 patients with metastatic neuroendocrine tumors with hepatic metastases treated with HAE, HACE, or SIRT at the University of Iowa from 2001 to 2011 were analyzed.
  
  
  RESULTS
  A total of 13 patients had HAE, 17 patients had HACE, and 12 patients had SIRT as their initial procedure. Time to progression (TTP) was similar between SIRT (15.1 months) and HACE/HAE groups (19.6 months; P = 0.968). There was a trend toward increased TTP in patients receiving HACE (33.4 months) compared with HAE (12.1 months) or SIRT (15.1 months), although not statistically significant (P = 0.512). The overall survival for all patients from the first intervention was 41.9 months. There was no difference between HACE/HAE and SIRT in posttherapy change of chromogranin A (P = 0.233) and pancreastatin (P = 0.158) levels. Time to progression did not correlate with the change in the posttherapy chromogranin A (P = 0.299) or pancreastatin (P = 0.208) levels.
  
  
  CONCLUSIONS
  There was no significant difference in TTP in patients treated with SIRT compared with patients treated with HAE or HACE. Baseline and posttherapy marker changes were not predictive of TTP.
authors: From the *Division of Hematology, Oncology, and Bone and Marrow Transplantation, the Holden Comprehensive Cancer Center, and †Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA; ‡New Mexico Cancer Center, Albuquerque, NM; §Department of Radiology, and ∥Division of Surgical Oncology, University of Iowa Hospitals and Clinics; ¶College of Public Health, University of Iowa Carver College of Medicine, Iowa City, IA; and #Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, AZ.
authors: Eric S
authors: ES
authors: Engelman
authors: Roberto
authors: R
authors: Leon-Ferre
authors: Boris G
authors: BG
authors: Naraev
authors: Nancy
authors: N
authors: Sharma
authors: Shiliang
authors: S
authors: Sun
authors: Thomas M
authors: TM
authors: O'Dorisio
authors: James
authors: J
authors: Howe
authors: Anna
authors: A
authors: Button
authors: Gideon
authors: G
authors: Zamba
authors: Thorvardur R
authors: TR
authors: Halfdanarson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D053379:Chromogranin A / Q000378:metabolism; D018450:Disease Progression; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D005334:Fever / Q000209:etiology; D006499:Hepatic Artery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010187:Pancreatic Hormones / Q000378:metabolism; D016016:Proportional Hazards Models; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D013997:Time Factors; D014839:Vomiting / Q000209:etiology
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D010187:Pancreatic Hormones; C050836:pancreastatin