title: Safety and efficacy of doxorubicin-eluting superabsorbent polymer microspheres for the treatment of liver metastases from neuroendocrine tumours: preliminary results.
abstract: BACKGROUND
  The aim of the study was to retrospectively evaluate the symptom control, tumour response, and complication rate in patients with liver-predominant metastatic neuroendocrine tumours treated with transarterial chemoembolization using doxorubicin-eluting superabsorbent polymer (SAP) microspheres.
  
  
  METHODS
  Patients with neuroendocrine liver metastases who underwent hepatic transarterial chemoembolization using doxorubicin-eluting SAP-microspheres (50-100 μm Hepasphere/Quadrasphere Microsphere® particles, Merit Medical, South Jordan, Utah, USA) were included in this study. Pre-and post-procedure imaging studies were evaluated to assess short and intermediate-term tumour response using modified RECIST criteria. Symptom relief and procedure-related complications were evaluated.
  
  
  RESULTS
  A total of 27 embolization procedures were performed on 17 patients. Twelve of 17 patients (70%) were symptomatic, including carcinoid syndrome (n = 8) and severe, uncontrollable hypoglycemia (n = 4). Eight of 12 patients (67%) had complete symptom relief, and the remaining 4 (33%) had partial relief. One patient developed ischemic cholecystitis (6%). No other hepatobiliary complications occurred. Short-term and intermediate-term imaging follow-up was available for 15/17 patients (88%) and 12/14 patients (86%) respectively. At short-term follow-up (< 3 months), 14 patients (93%) showed partial response and the remaining patient had progressive disease (7%). At intermediate-term imaging follow-up (> 3 months), partial response, stable disease and progressive disease were found respectively in 7 (58%), 3 (25%) and 2 (17%) patients.
  
  
  CONCLUSIONS
  Chemoembolization with doxorubicin-eluting SAP-microspheres is a safe and effective treatment option for neuroendocrine liver metastases and is associated with a low complication rate. In particular, no clinically evident liver necrosis or bile duct complications were encountered.
authors.affiliation: Department of Radiology, University Hospitals Leuven, Belgium.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Bonne
authors.affiliation: Department of Hepatology and Gastroenterology, University Hospitals Leuven, Belgium.
authors.forename: Chris
authors.initials: C
authors.lastname: Verslype
authors.affiliation: Interuniversity Centre for Biostatistics and Statistical Bioinformatics, Catholic University of Leuven and University Hasselt, Belgium.
authors.forename: Annouschka
authors.initials: A
authors.lastname: Laenen
authors.affiliation: Department of Radiology, University Hospitals Leuven, Belgium.
authors.forename: Sandra
authors.initials: S
authors.lastname: Cornelissen
authors.affiliation: Department of Nuclear Medicine, University Hospitals Leuven, Belgium.
authors.forename: Christophe M
authors.initials: CM
authors.lastname: Deroose
authors.affiliation: Department of Hepatology and Gastroenterology, University Hospitals Leuven, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Prenen
authors.affiliation: Department of Radiology, University Hospitals Leuven, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vandecaveye
authors.affiliation: Department of Hepatology and Gastroenterology, University Hospitals Leuven, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Van Cutsem
authors.affiliation: Department of Radiology, University Hospitals Leuven, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Maleux
keywords: chemoembolization; drug-eluting beads; neuroendocrine tumour; procedure-related complications