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Intra-arterial therapy of neuroendocrine tumour liver metastases: comparing conventional TACE, drug-eluting beads TACE and yttrium-90 radioembolisation as treatment options using a propensity score analysis model

    作者

    Minh, DD;Chapiro, J;Gorodetski, B;Huang, Q;Liu, CH;Smolka, S;Savic, LJ;Wainstejn, D;Lin, MD;Schlachter, T;Gebauer, B;Geschwind, JF

    作者单位

    [Minh, Duc Do; Gorodetski, Boris; Smolka, Susanne; Savic, Lynn Jeanette; Wainstejn, David; Gebauer, Bernhard] Charite, Dept Diagnost & Intervent Radiol, Campus Virchow Klinikum, Berlin, Germany.;-;[Minh, Duc Do; Chapiro, Julius; Gorodetski, Boris; Huang, Qiang; Liu, Cuihong; Smolka, Susanne; Savic, Lynn Jeanette; Wainstejn, David; Lin, MingDe; Schlachter, Todd; Geschwind, Jean-Francois] Yale Univ, Sch Med, Dept Radiol & Biomed Imaging, 333 Cedar St, New Haven, CT 06520 USA.;-;[Huang, Qiang] Capital Med Univ, Beijing Chaoyang Hosp, Dept Intervent Radiol, Beijing, Peoples R China.;-;[Liu, Cuihong] Shandong Univ, Shandong Prov Hosp, Dept Ultrasound, Jinan, Peoples R China.;-;[Lin, MingDe] Philips Res North Amer, US Imaging & Intervent UII, Cambridge, MA USA.;-;[Geschwind, Jean-Francois] Yale Univ, Sch Med, Dept Radiol & Biomed Imaging, 330 Cedar St,TE 2-230, New Haven, CT 06520 USA.

    摘要

    To compare efficacy, survival outcome and prognostic factors of conventional transarterial chemoembolisation (cTACE), drug-eluting beads TACE (DEB-TACE) and yttrium-90 radioembolisation (Y90) for the treatment of liver metastases from gastroenteropancreatic (GEP) neuroendocrine tumours (NELM).;-;This retrospective analysis included 192 patients (58.6 years mean age, 56% men) with NELM treated with cTACE (N = 122), DEB-TACE (N = 26) or Y90 (N = 44) between 2000 and 2014. Radiologic response to therapy was assessed according to Response Evaluation Criteria in Solid Tumours (RECIST) and World Health Organization (WHO) criteria using periprocedural MR imaging. Survival analysis included propensity score analysis (PSA), median overall survival (MOS), hepatic progression-free survival, Kaplan-Meier using log-rank test and the uni- and multivariate Cox proportional hazards model (MVA).;-;MOS of the entire study population was 28.8 months. As for cTACE, DEB-TACE and Y90, MOS was 33.8 months, 21.7 months and 23.6 months, respectively. According to the MVA, cTACE demonstrated a significantly longer MOS as compared to DEB-TACE (p <.01) or Y90 (p = .02). The 5-year survival rate after initial cTACE, DEB-TACE and Y90 was 28.2%, 10.3% and 18.5%, respectively.;-;Upon PSA, our study suggests significant survival benefits for patients treated with cTACE as compared to DEB-TACE and Y90. This data supports the therapeutic decision for cTACE as the primary intra-arterial therapy option in patients with unresectable NELM until proven otherwise.;-;aEuro cent cTACE achieved a significantly longer overall survival in patients with unresectable NELM.;-;aEuro cent Patients treated with cTACE showed a prolonged hepatic progression-free survival.;-;aEuro cent cTACE, DEB-TACE and Y90 radioembolisation demonstrated comparable safety and toxicity profiles.;-;aEuro cent Age > 70 years, extrahepatic metastases and tumour burden > 50% were identified as negative predictors.;-;aEuro cent Propensity score analysis suggests the superiority of cTACE over DEB-TACE and Y90.

    关键词

    TRANSARTERIAL CHEMOEMBOLIZATION; HEPATIC METASTASES; ARTERIAL EMBOLIZATION; CARCINOID-TUMORS; ENDOCRINE TUMORS; MANAGEMENT; GUIDELINES; SURVIVAL; RATES
基本信息

  • 所属机构:

    归属医师: 刘翠红

    PMID:28677067

    UT:000414671000012

    刊名:EUROPEAN RADIOLOGY

    年,卷(期):2017年27卷12期

    页码:4995-5005

    DOI:10.1007/s00330-017-4856-2

    附件:

    收录:   SCIE