Radioembolisation with 90Y microspheres for neuroendocrine liver metastases: an institutional case series, systematic review and meta-analysis
File(s)
Author(s)
Type
Journal Article
Abstract
BACKGROUND: Neuroendocrine liver metastases are clinically challenging due to their frequent disseminated distribution. This study aims to present a British experience with an emerging modality, radioembolisation with yttrium-90 labelled microspheres, and embed this within a meta-analysis of response and survival outcomes. METHODS: A retrospective case series of patients treated with SIR-Spheres (radiolabelled resin microspheres) was performed. Results were included in a systematic review and meta-analysis of published results with glass or resin microspheres. Objective response rate (ORR) was defined as complete or partial response. Disease control rate (DCR) was defined as complete/partial response or stable disease. RESULTS: Twenty-four patients were identified. ORR and DCR in the institutional series was 14/24 and 21/24 at 3 months. Overall survival and progression-free survival at 3-years was 77.6% and 50.4%, respectively. There were no grade 3/4 toxicities post-procedure. A fixed-effects pooled estimate of ORR of 51% (95% CI: 47%-54%) was identified from meta-analysis of 27 studies. The fixed-effects weighted average DCR was 88% (95% CI: 85%-90%, 27 studies). CONCLUSION: Current data demonstrate evidence of the clinical effectiveness and safety of radioembolisation for neuroendocrine liver metastases. Prospective randomised studies to compare radioembolisation with other liver directed treatment modalities are needed.
Date Issued
2019-07-01
Date Acceptance
2018-12-11
Citation
HPB, 2019, 21 (7), pp.773-783
ISSN
1365-182X
Publisher
Elsevier
Start Page
773
End Page
783
Journal / Book Title
HPB
Volume
21
Issue
7
Copyright Statement
© 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.
Sponsor
Dr. Heinz-Horst Deichmann Stiftung
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30733049
PII: S1365-182X(19)30024-3
Grant Number
n/a
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Surgery
SELECTIVE INTERNAL RADIATION
Y-90 RADIOEMBOLIZATION
HEPATIC METASTASES
DIRECTED THERAPIES
PROGNOSTIC-FACTORS
TUMORS
MANAGEMENT
SURVIVAL
EMBOLIZATION
EXPERIENCE
Surgery
1103 Clinical Sciences
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-02-05