Purpose: The aim of this study was to examine the efficacy of intra-arterial (90)Yttrium treatment in the management of unresectable hepatic neuroendocrine tumors (NET) metastases unresponsive to treatment and the role of (111)In-octreotide scintigraphy in the evaluation of treatment response.
Methods: Thirteen (13) patients with a mean age of 53.3 years not eligible for surgical treatment were included. Before the procedure, routine tests for renal/hepatic functions and bilirubin levels as well as (99m)Tc-macroaggregated albumin test to detect any leakage to the lungs were done. Treatment doses were calculated using body surface area method and all patients received (90)Y resin microspheres through hepatic artery catheter. Abdominopelvic computed tomography (CT) and (111)In-octreotide scintigraphy were done before and after treatment. Patients were divided into two groups based on their treatment response as assessed by either (111)In-octreotide scintigraphy or CT: group 1, responders; group 2, nonresponders.
Results: For all patients, 1-year survival rate and overall survival was 84.7% and 20 months, respectively. Based on (111)In-octreotide scintigraphy findings, 1-year survival rate was 90% and 66.7% for responders and nonresponders, respectively, whereas corresponding overall survival was 21.3 months and 15.3 months. Survival data based on CT findings were as follows: 1-year survival rate, responders, 80%; nonresponders, 100%; overall survival, responders, 20.4 months, nonresponders, 18.5 months.
Conclusions: Intra-arterial treatment with (90)Y has survival benefits in treatment-refractory liver metastases from NETs and it could be used in these patients. Since it is a functional imaging method, (111)In-octreotide scintigraphy may be better discriminates patients responding to treatment from patients not responding.