Y-90 Radioembolization in the Treatment of Neuroendocrine Neoplasms: Results of an International Multicenter Retrospective Study

Schaarschmidt, Benedikt M.; Wildgruber, Moritz; Kloeckner, Roman; Nie, James; Steinle, Verena; Braat, Arthur J. A. T.; Lohoefer, Fabian; Kim, Hyun S.; Lahner, Harald; Weber, Manuel und Theysohn, Jens (2022): Y-90 Radioembolization in the Treatment of Neuroendocrine Neoplasms: Results of an International Multicenter Retrospective Study. In: Journal of Nuclear Medicine, Bd. 63, Nr. 5: S. 679-685

Abstract

In neuroendocrine neoplasms (NENs), the presence of distant metastases has a severe impact on survival leading to a relevant decrease in the 5-y survival rate. Here, Y-90 radioembolization (Y-90 RE) might be an important treatment option;however, data to support clinical benefits for Y-90 RE are scarce. Therefore, the purpose of this study was to analyze the use of Y-90 RE in NEN patients with hepatic metastases in an international, multicenter retrospective analysis and assess the potential role of Y-90 RE in a multimodal treatment concept. Methods: In total, 297 angiographic evaluations in NEN patients before Y-90 RE were analyzed. Baseline characteristics and parameters derived from imaging evaluation and Y-90 RE were analyzed. Tumor response was assessed using RECIST 1.1, and survival data were collected. Mean overall survival (OS) between different groups was compared using Kaplan-Meier curves and the log rank test. A P value of less than 0.05 indicated statistical significance. Results: After Y-90 RE, the disease control rate according to RECIST 1.1 was 83.5% after 3 mo and 50.9% after 12 mo. OS in the entire population was 38.9 +/- 33.0 mo. High tumor grade (P < 0.006) and high tumor burden (P = 0.001) were both associated with a significant decrease in OS. The presence of extrahepatic metastases (P = 0.335) and the type of metastatic vascularization pattern (P = 0.460) had no influence on OS. Patients who received Y-90 RE as second-line therapy had a slightly longer but not statistically significant OS than patients who had Y-90 RE in a salvage setting (44.8 vs. 30.6 mo, P = 0.078). Hepatic and global progression-free survival after Y-90 RE was significantly decreased in heavily pretreated patients, compared with patients with second-line therapy (P = 0.011 and P = 0.010, respectively). Conclusion: Y-90 RE could be an important alternative to peptide receptor radionuclide therapy as second-line treatment in patients with progressive liver-dominant disease pretreated with somatostatin analogs.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0161-5505
• Sprache: Englisch