Transarterial chemoembolization and selective internal radiation for the treatment of patients with metastatic neuroendocrine tumors

A comparison of efficacy and cost

Ryan Whitney, Vlatimil Vàlek, Joan Falco Fages, Agustin Garcia, Govindarajan Narayanan, Cliff Tatum, Mike Hahl, Robert C G Martin

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)594-601
Number of pages8
JournalOncologist
Volume16
Issue number5
DOIs
StatePublished - Jun 22 2011

Fingerprint

Neuroendocrine Tumors
Radiation
Costs and Cost Analysis
Yttrium
Doxorubicin
Therapeutics
Liver
Pharmaceutical Preparations
Safety
Drug Costs
Research Ethics Committees
Microspheres
Health Care Costs
Registries

Keywords

  • Chemoembolization
  • Doxorubicin
  • Liver directed therapy
  • Metastatic neuroendocrine
  • Yttrium-90

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Transarterial chemoembolization and selective internal radiation for the treatment of patients with metastatic neuroendocrine tumors : A comparison of efficacy and cost. / Whitney, Ryan; Vàlek, Vlatimil; Fages, Joan Falco; Garcia, Agustin; Narayanan, Govindarajan; Tatum, Cliff; Hahl, Mike; Martin, Robert C G.

In: Oncologist, Vol. 16, No. 5, 22.06.2011, p. 594-601.

Research output: Contribution to journalArticle

Whitney, Ryan ; Vàlek, Vlatimil ; Fages, Joan Falco ; Garcia, Agustin ; Narayanan, Govindarajan ; Tatum, Cliff ; Hahl, Mike ; Martin, Robert C G. / Transarterial chemoembolization and selective internal radiation for the treatment of patients with metastatic neuroendocrine tumors : A comparison of efficacy and cost. In: Oncologist. 2011 ; Vol. 16, No. 5. pp. 594-601.
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