Transarterial radioembolization in neuroendocrine liver metastases 25 years later: A systematic review

Federico Garrou; Gian Mauro Sacchetti; Lucia Leva; Paolo Andreatta; Marco Brambilla; Silvia Morbelli; Alessandro Carriero

doi:10.1016/j.critrevonc.2025.104697

Transarterial radioembolization in neuroendocrine liver metastases 25 years later: A systematic review

Crit Rev Oncol Hematol. 2025 Jun:210:104697. doi: 10.1016/j.critrevonc.2025.104697. Epub 2025 Mar 15.

Authors

Federico Garrou¹, Gian Mauro Sacchetti², Lucia Leva², Paolo Andreatta³, Marco Brambilla³, Silvia Morbelli⁴, Alessandro Carriero⁵

Affiliations

¹ Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy; Nuclear Medicine Unit, AOU Maggiore della Carità, Novara, Italy. Electronic address: federico.garrou@unito.it.
² Nuclear Medicine Unit, AOU Maggiore della Carità, Novara, Italy.
³ Medical Physics Department, AOU Maggiore della Carità, Novara, Italy.
⁴ Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy; Nuclear Medicine Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
⁵ Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.

PMID: 40096872
DOI: 10.1016/j.critrevonc.2025.104697

Abstract

Transarterial Radioembolization (TARE) currently lacks a defined role in treating neuroendocrine liver metastases (NELM). This systematic review aims to clarify TARE's role based on its prognostic impact. A search identified 138 studies onPubMed/MEDLINE over the past 25 years, focusing on TARE for NELM patients. Of these, 46 studies met eligibility criteria, and 11 were selected for their similar settings, populations, and outcomes. These were grouped into three clusters based on survival outcomes: overall survival (OS), hepatic progression-free survival (HPFS), and imaging response (IR) per RECIST 1.1 criteria. Statistical analyses showed a median OS of 33 months for 809 patients, a median HPFS of 24 months for 414 patients, and an IR of 28.6 % complete or partial response, 57.8 % stable disease, and 13.6 % disease progression in 581 patients. This evidence supports TARE as a viable treatment option, but further studies are needed to optimize its use and dosimetric procedures.

Keywords: Glass; Microsphere; NET; Neuroendocrine tumors; Resin; TARE; Transarterial radioembolization; Yttrium.

Publication types

Systematic Review

MeSH terms

Embolization, Therapeutic* / methods
Humans
Liver Neoplasms* / mortality
Liver Neoplasms* / radiotherapy
Liver Neoplasms* / secondary
Liver Neoplasms* / therapy
Neuroendocrine Tumors* / mortality
Neuroendocrine Tumors* / pathology
Neuroendocrine Tumors* / therapy
Treatment Outcome