REGULAR CONTENT
Final ID
496
Type
Original Scientific Research-Oral or Pos
Authors
J Gutovich1, G Lipshutz1, R Van Allan1, R Saouaf1, K Butenschoen1, B Allegretto1, A Hendifar1, J Mirocha1, F Amersi1, A Annamalai1, N Nissen1, M Friedman1
Institutions
1Cedars-Sinai Medical Center, Los Angeles, CA
Purpose
To evaluate factors associated with disease progression and complications in patients with metastatic neuroendocrine tumor to the liver that were treated with transarterial radioembolization using Y-90.
Materials & Methods
Between 2007-2016, fifty-six patients (mean age 59; 26 male and 30 female) with metastatic neuroendocrine tumor (NET) to the liver were treated with radioembolization using Y-90. Fifty-five patients received resin and one patient received glass microspheres. Twenty-five patients underwent single lobe and thirty-one patients received bilobar radioembolization. Forty-four patients had small volume extrahepatic disease at the time of radioembolization. Treatment response was based on follow-up MRI imaging and clinical documentation. Overall and progression free survival was calculated using Kaplan Meier estimates. Common Terminology Criteria for Adverse Events (CTCAEv4.0) was used to assess treatment related adverse effects.
Results
The average activity delivered was 1.78 GBq. The median follow up time was 17 months (range 1-97 months). The 1 and 2 year overall survival (OS) was 94% and 88%. The median progression free survival was 3.95 years (95% CI 2.44-4.55). The 1 and 2 year progression free survival was 85 % and 68%. Patient's age, delivered dose, gender, presence of extrahepatic disease, bilobar intrahepatic disease and greater than 50% of hepatic involvement were not predictors of an increased rate of disease progression post radioembolization (all P-Values > 0.05). There was a trend toward a faster rate of disease progression for metastatic pancreatic neuroendocrine tumor post radioembolization compared to neuroendocrine tumor of bowel origin (HR=2.78; 95% CI 0.95-8.11). Eleven patients (20%) had documented grade 3 toxicities, while one patient (0.02%) had a grade 4 toxicity.
Conclusions
The current study further supports Y-90 radioembolization as an effective and safe treatment for metastatic neuroendocrine tumor to the liver. An analysis of covariants demonstrated a trend towards decreased progression free survival for neuroendocrine tumor of pancreatic origin.
Final ID
496
Type
Original Scientific Research-Oral or Pos
Authors
J Gutovich1, G Lipshutz1, R Van Allan1, R Saouaf1, K Butenschoen1, B Allegretto1, A Hendifar1, J Mirocha1, F Amersi1, A Annamalai1, N Nissen1, M Friedman1
Institutions
1Cedars-Sinai Medical Center, Los Angeles, CA
Purpose
To evaluate factors associated with disease progression and complications in patients with metastatic neuroendocrine tumor to the liver that were treated with transarterial radioembolization using Y-90.
Materials & Methods
Between 2007-2016, fifty-six patients (mean age 59; 26 male and 30 female) with metastatic neuroendocrine tumor (NET) to the liver were treated with radioembolization using Y-90. Fifty-five patients received resin and one patient received glass microspheres. Twenty-five patients underwent single lobe and thirty-one patients received bilobar radioembolization. Forty-four patients had small volume extrahepatic disease at the time of radioembolization. Treatment response was based on follow-up MRI imaging and clinical documentation. Overall and progression free survival was calculated using Kaplan Meier estimates. Common Terminology Criteria for Adverse Events (CTCAEv4.0) was used to assess treatment related adverse effects.
Results
The average activity delivered was 1.78 GBq. The median follow up time was 17 months (range 1-97 months). The 1 and 2 year overall survival (OS) was 94% and 88%. The median progression free survival was 3.95 years (95% CI 2.44-4.55). The 1 and 2 year progression free survival was 85 % and 68%. Patient's age, delivered dose, gender, presence of extrahepatic disease, bilobar intrahepatic disease and greater than 50% of hepatic involvement were not predictors of an increased rate of disease progression post radioembolization (all P-Values > 0.05). There was a trend toward a faster rate of disease progression for metastatic pancreatic neuroendocrine tumor post radioembolization compared to neuroendocrine tumor of bowel origin (HR=2.78; 95% CI 0.95-8.11). Eleven patients (20%) had documented grade 3 toxicities, while one patient (0.02%) had a grade 4 toxicity.
Conclusions
The current study further supports Y-90 radioembolization as an effective and safe treatment for metastatic neuroendocrine tumor to the liver. An analysis of covariants demonstrated a trend towards decreased progression free survival for neuroendocrine tumor of pancreatic origin.