The Evolving Role of Radioembolization in the Treatment of Neuroendocrine Liver Metastases
Abstract
:Simple Summary
Abstract
1. Introduction
2. How Is Radioembolization Performed?
3. SIRT in NEN: Salvage Setting
4. Radioembolization in Earlier Lines or Combinations Treatments
5. Concerns, Limitations and Future Perspectives
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Clinical Assessment | Laboratory Testing | Imaging Work-Up |
---|---|---|
Minimal | ||
ECOG performance score | Bilirubin, ALP, AST, ALT, albumin | gdMRI/CECT for intrahepatic tumor load 1 |
Signs of hepatic dysfunction (Child–Pugh score) | Creatinine, eGFR | Early-phase CECT for arterial vasculature |
NET hormone-related symptoms | Tumor markers (e.g., CgA, gastrin) | |
Additional | ||
In selected cases, Fibroscan or gastroscopy to assess esophageal varices | Hb, hematocrit, WBC, platelets | SSTR-PET/CT for total body tumor load 1 |
Coagulation (e.g., Prothrombin time or INR) | FDG-PET/CT for tumor grade distinction, excluding aggressive disease. |
Year | N | ORR * | DCR * | PFS | OS | REILD | |
---|---|---|---|---|---|---|---|
% | % | Months | Months | n (%) | |||
Devcic et al. † [10] | 2014 | 435 | 50 | 86 | NR | 28.5 | NR |
Peker et al. [18] | 2015 | 38 | 46 | 83 | NR | 39 | 0 |
Barbier et al. [19] | 2016 | 54 | 54 | 94 | NR | 34.8 | 1 (1.8) |
Braat et al. [9] | 2019 | 244 | 16 | 91 | NR | 31 | 2 (0.8) |
43 | 91 | ||||||
Schaarschmidt et al. [20] | 2022 | 297 | 41.3 | 83.5 | 15.9 | 30.6 | 2 (0.8) |
Wong et al. [21] | 2022 | 170 | 36 | 69 | 25 | 33 | 1 (0.6) |
Author | Year | n | Population | Procedures | ORR * | PFS † | OS |
---|---|---|---|---|---|---|---|
Soulen et al. [26] | 2018 | 21 | Grade 2 NELM | capecitabin 600 mg/m2 twice daily for 14 days temozolomide 150 to 200 mg/m2 in divided on days 10 to 14. 90Y resin radioembolization 7th day of cycle 2 | 74% | NR | NR |
Kim et al. [27] | 2018 | 13 | Grade 1 + 2 NELM | 3 + 3 dose escalation of everolimus 2,5–5–10 mg Pasitreotide 600 µg twice daily 90Y resin radioembolization day 9 and 37 | 46% | 18.6 | 46.3 |
Braat et al. [28] | 2020 | 31 | Grade 1 + 2 NELM | Standard 4 cycles of 7.4 GBq 177Lu-PRRT 166Ho-radioembolization <20 weeks after 4th PRRT | 43% | 30.1 | 40.8 |
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Ramdhani, K.; Braat, A.J.A.T. The Evolving Role of Radioembolization in the Treatment of Neuroendocrine Liver Metastases. Cancers 2022, 14, 3415. https://doi.org/10.3390/cancers14143415
Ramdhani K, Braat AJAT. The Evolving Role of Radioembolization in the Treatment of Neuroendocrine Liver Metastases. Cancers. 2022; 14(14):3415. https://doi.org/10.3390/cancers14143415
Chicago/Turabian StyleRamdhani, Khalil, and Arthur J. A. T. Braat. 2022. "The Evolving Role of Radioembolization in the Treatment of Neuroendocrine Liver Metastases" Cancers 14, no. 14: 3415. https://doi.org/10.3390/cancers14143415