Background: The purpose of this study was to evaluate the clinical, biological and radiological responses to, and tolerability of, conventional transarterial chemoembolization (cTACE) using streptozocin for unresectable neuroendocrine liver metastases. Patients and Methods: A total of 52 patients with predominant liver disease were treated with cTACE using an emulsion of streptozocin, Lipiodol and embolization particles. A sequential approach was favored in patients with high liver tumor burden. Clinical, biological and radiological responses were evaluated using carcinoid symptoms, biomarkers and mRecist criteria, respectively. Results: A total of 127 procedures were performed with a sequential approach in 65% of patients. All patients received streptozocin and Lipiodol. Carcinoid syndrome was improved in 69% of patients after treatment (p= 0.01). Post-embolization syndrome was reported in 78% of patients. At the end of all cTACE, objective response and non-progressive disease were 32% and 70%, respectively. Progression-free survival was 18.3 ± 13.3 months (median 14.9) and median overall survival (OS) from start of treatment was 74 months. The OS at 1 year, 2 years, 3 years and 5 years was 91% (IC = 84–99%), 84% (CI = 72–95%), 69% (CI = 53–84%) and 63% (C = 46–81%), respectively. Conclusions: cTACE using streptozocin is an effective and well-tolerated palliative option for patients with neuroendocrine liver metastases, associated with prolonged survival and delayed time to progression.
背景：本研究旨在评估使用链脲佐菌素的传统经动脉化疗栓塞术（cTACE）治疗不可切除神经内分泌肝转移瘤的临床、生物学及影像学反应与耐受性。患者与方法：共52例以肝脏病变为主的患者接受了链脲佐菌素、碘油和栓塞颗粒混合乳剂的cTACE治疗。对于肝肿瘤负荷较高的患者，优先采用序贯治疗策略。分别通过类癌症状、生物标志物和mRECIST标准评估临床、生物学及影像学反应。结果：共进行127次手术，其中65%的患者采用序贯治疗。所有患者均接受了链脲佐菌素和碘油治疗。治疗后69%的患者类癌综合征得到改善（p=0.01）。78%的患者出现栓塞后综合征。在所有cTACE治疗结束时，客观缓解率和疾病非进展率分别为32%和70%。无进展生存期为18.3±13.3个月（中位数14.9个月），治疗开始后的中位总生存期为74个月。1年、2年、3年和5年总生存率分别为91%（置信区间84–99%）、84%（置信区间72–95%）、69%（置信区间53–84%）和63%（置信区间46–81%）。结论：使用链脲佐菌素的cTACE是治疗神经内分泌肝转移瘤有效且耐受性良好的姑息性治疗方案，可延长患者生存期并延缓疾病进展时间。
肿瘤(癌症)患者之家