Selective internal radiation therapy in patients with progressive neuroendocrine liver metastases

Eur J Nucl Med Mol Imaging. 2016 Jul;43(8):1425-31. doi: 10.1007/s00259-015-3264-6. Epub 2015 Dec 3.


Purpose: To evaluate the safety and efficacy of selective internal radiation therapy (SIRT) in patients with unresectable liver metastases from neuroendocrine tumours (NETLMs).

Methods: This retrospective study included 40 patients with progressive NETLMs (22 women, 18 men, mean age 61.6 years) who underwent SIRT with (90)Y-labelled resin microspheres. Tumour response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) on CT or MR images. Medical records were reviewed.

Results: In the 40 patients, 54 evaluable SIRT procedures were performed, 33 to the right liver lobe (mean activity 1.31 GBq), 13 to the left lobe (mean activity 0.85 GBq), and 8 to both lobes (mean activity 1.61 GBq). Late follow-up imaging (mean 20 months) was performed after 44 of the treatments. Objective tumour response and disease control rates were 54 % (29 of 54 treatments) and 94 % (51 treatments), respectively, at the early follow-up examination (mean 3 months) and 34 % (15 treatments) and 57 % (25 treatments), respectively at the late follow-up examination. Mean overall survival from the first SIRT was 34,8 months and survival rates at 1, 2, 3 and 5 years were 76 %, 59 %, 52 % and 35 % respectively. Adverse effects were generally mild and easily manageable, except in one patient who died from radiation-induced liver failure. Of the 45 patients, 18 (45 %) had received peptide receptor radionuclide therapy (PRRT) prior to SIRT.

Conclusion: SIRT with (90)Y-labelled resin microspheres is a safe and effective treatment for patients with progressive NETLM, and also for those who have received prior PRRT.

Keywords: Neuroendocrine liver metastases; Selective internal radiation therapy; Transarterial; Yttrium.

MeSH terms

  • Adult
  • Aged
  • Disease Progression
  • Female
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / pathology*
  • Retrospective Studies
  • Treatment Outcome