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Endocrine Abstracts (2014) 35 P548 | DOI: 10.1530/endoabs.35.P548

1Clinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; 2Institute for Radiology, Belgrade, Serbia.


Background: Trans-catheter arterial chemoembolization (TACE) is a method of treatment of unresectable liver metastases from neuroendocrine tumours (NETs) which is effective in the control of symptoms and tumour growth.

Aim: To evaluate clinical outcome: radiologic, biologic, symptomatic response and safety of TACE procedure.

Method: 31 patients underwent 140 TACE procedures during 2003–2011. Tumour responses were measured by CT and MRI, and were assessed using the RECIST criteria.

Results: NETs originated from pancreas (n=5), small bowel (n=11), colon (n=1), lung (n=5), unknown primary localization (n=9). According to WHO/ENETs criteria, majority were NETs G1–G2. Almost all patients had received other medical treatment. Tumour response: none of the 31 patients had complete response. After third TACE a partial response was observed in two patients, stable disease in eight patients, and there was none of the patient with progressive disease. After the third TACE partial response was observed in three, stable disease in five and progressive disease in four patients. Biologic response: increased values of CgA were found in 82% patients. There was statistically significant correlation between radiological response and plasma CgA levels (r=0.517, P=0.008). Symptomatic response: all patients reported symptom improvement (diarrhoea, flushing) after first TACE. Carcinoid syndrome was less controlled after third TACE (83%). The correlation between radiological response and urinary 5HIAA level also existed, but it was not statistically significant. Safety: all patients experienced some form of postembolization syndrome. Serious adverse events were noted after 12 TACE (8.6%) in six patients, without treatment-related deaths. Severe complications were kidney failure associated with tumour lysis syndrome and DIK in two patients and carcinoid crisis in four patients.

Conclusion: TACE is effective and safe treatment for patients with hepatic metastases from NETs. The goals of treatment include radiologic response or disease stabilization, symptom and biochemical control, and improvement in quality of life.

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