Abstract No. 350 - Clinical and imaging response in neuroendocrine hepatic metastasis treated with Y-90 radioembolization

Abstract

Purpose To evaluate both the clinical and imaging response of unresectable hepatic neuroendocrine metastasis after treatment with Y-90 microsphere radioembolization. Materials and Methods This is a single institution retrospective review of 26 patients with neuroendocrine hepatic metastasis treated with Y-90 microsphere radioembolization. Clinical symptoms, biochemical markers and imaging at regular intervals of 1, 3, 6, 12 and 18 months post-procedure were reviewed. The patient's clinical and imaging response were evaluated. Other medical and interventional therapies were recorded. The two largest hepatic lesions were measured and tumor response was determined by RECIST 1.1 criteria. Results There were equal numbers of males and females. The mean patient age was 60, with a range of 26 to 88. Primary neuroendocrine sites were the small bowel (10), pancreas (6), colon and rectum (4), other (4) and unknown (2). Six patients (23%) underwent prior open radiofrequency ablation therapy. Twenty-one patients (81%) also received transarterial chemoembolizations. Most patients (77%) had a single Y-90 treatment. All patients had been treated with octreotide. Partial response was seen in 11 patients (42%), stable disease in 13 patients (50%) and progressive disease in 2 patients (8%). Biochemical marker response was evenly split, half increasing and half decreasing after therapy. Symptomatic improvement was noted in 18 patients (69%). Both patients with progressive disease had symptomatic improvement. Conclusion It has been shown that Y-90 microsphere radioembolization is a safe and effective therapy for hepatic neuroendocrine metastasis. Our data shows that this therapy also improves clinical symptoms. While further evaluation is needed, radioembolization may be able to play a larger role in the management of clinical symptoms.