Document Detail


Transarterial chemoembolization and selective internal radiation for the treatment of patients with metastatic neuroendocrine tumors: a comparison of efficacy and cost.
MedLine Citation:
PMID:  21508068     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hepatic arterial therapy (HAT) has been proven to be effective at palliation of hormonal symptoms of metastatic neuroendocrine tumors (NETs), as well as a means of cytoreduction. Recently, the newer modalities of yttrium-90 and drug-eluting beads with doxorubicin (DEBDOX) have been reported to be effective in the treatment of metastatic NETs. The aim of this study was to compare the safety, efficacy, and cost of selective internal radiation with DEB therapy.
METHODS: An institutional review board-approved, multicenter, multinational prospective treatment registry to investigate the safety and efficacy of yttrium-90 and doxorubicin microspheres was reviewed.
RESULTS: In all, 43 patients underwent a combined 69 HAT treatments, with 15 patients receiving 23 yttrium-90 treatments and 28 patients receiving 46 DEBDOX treatments. The extent of disease-based on the number of lesions, bilobar distribution, patient performance status, and size of largest lesion-was similar in both the yttrium-90 and DEBDOX groups. After a median follow-up of 12 months, response rates were similar with the two treatments, but then there was a significantly lower response rate in the yttrium-90 group at 12 months than in the DEBDOX group. In an evaluation of cost for the two treatments, the median cost for yttrium-90 was $25,243 and the median cost for DEBDOX was $13,400.
CONCLUSION: HAT is a safe and effective therapy in patients with unresectable NETs to the liver. The size of the lesions, total lesion volume, and expense of therapy need to be considered when choosing which HAT method is optimal.
Authors:
Ryan Whitney; Vlatimil Vàlek; Joan Falco Fages; Agustin Garcia; Govindarajan Narayanan; Cliff Tatum; Mike Hahl; Robert C G Martin
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-20
Journal Detail:
Title:  The oncologist     Volume:  16     ISSN:  1549-490X     ISO Abbreviation:  Oncologist     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-18     Completed Date:  2011-09-13     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  9607837     Medline TA:  Oncologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  594-601     Citation Subset:  IM    
Affiliation:
Division of Surgical Oncology, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Chemoembolization, Therapeutic*
Combined Modality Therapy
Cost-Benefit Analysis
Doxorubicin / adverse effects,  economics,  therapeutic use*
Female
Humans
Liver Neoplasms / secondary,  therapy*
Male
Middle Aged
Neuroendocrine Tumors / pathology*,  radiotherapy,  therapy*
Treatment Outcome
Yttrium Radioisotopes / adverse effects,  economics,  therapeutic use*
Chemical
Reg. No./Substance:
0/Yttrium Radioisotopes; 23214-92-8/Doxorubicin
Comments/Corrections

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