文章：

经动脉栓塞术治疗胃肠胰神经内分泌肿瘤肝转移：治疗反应是否预示生存获益？

Trans-Arterial Embolization for Liver Metastases of Gastroenteropancreatic Neuroendocrine Tumors: Response Indicates Survival Benefit?

原文发布日期：19 January 2025

DOI: 10.3390/cancers17020309

类型: Article

开放获取: 是

英文摘要：

Objective: To determine the impact of trans-arterial embolization (TAE) on overall survival (OS) in patients with liver metastases from gastroenteropancreatic neuroendocrine tumors (LM-GEP-NETs) and to identify factors that may influence tumor response to TAE treatment. Methods: This study included patients with histologically and radiologically confirmed LM-GEP-NETs who received TAE treatment at The First Affiliated Hospital, Sun Yat-sen University, between November 2016 and January 2023. Imaging responses were assessed using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) criteria. Tumor response was defined as complete or partial remission. Results: In total, 267 patients with LM-GEP-NETs were included. Patients with liver tumor burdens <25%, 25–50%, and ≥50% had progressively worse OS (p< 0.005). According to the RECIST criteria, 65.9% of patients exhibited tumor responses. Using the mRECIST criteria, 77.5% of patients showed tumor responses. Survival analyses with log-rank tests indicated that patients with tumor responses assessed using either the RECIST or mRECIST criteria had significantly better OS (p= 0.015 andp= 0.023, respectively). Further logistic regression analyses showed that early TAE (within 4 months after diagnosis of liver metastases) was associated with tumor responses assessed using RECIST or mRECIST. These results were further verified using propensity score matching and inverse probability treatment weighting adjusted datasets. Conclusions: A higher liver tumor burden was associated with poorer OS in patients with LM-GEP-NETs. Tumor response after TAE indicates survival benefits. Early TAE (within 4 months of diagnosis) was associated with better treatment responses.

摘要翻译： 

目的：探讨经动脉栓塞术（TAE）对胃肠胰神经内分泌肿瘤肝转移（LM-GEP-NETs）患者总生存期（OS）的影响，并识别可能影响TAE治疗肿瘤反应的因素。方法：本研究纳入2016年11月至2023年1月期间在中山大学附属第一医院接受TAE治疗、经组织学和影像学确诊的LM-GEP-NETs患者。采用实体瘤疗效评价标准（RECIST）1.1和改良RECIST（mRECIST）标准评估影像学反应。肿瘤反应定义为完全缓解或部分缓解。结果：共纳入267例LM-GEP-NETs患者。肝脏肿瘤负荷<25%、25–50%和≥50%的患者OS逐渐恶化（p<0.005）。根据RECIST标准，65.9%的患者出现肿瘤反应。采用mRECIST标准时，77.5%的患者显示肿瘤反应。对数秩检验生存分析表明，使用RECIST或mRECIST标准评估获得肿瘤反应的患者OS显著更优（分别为p=0.015和p=0.023）。进一步的逻辑回归分析显示，早期TAE（肝转移诊断后4个月内）与使用RECIST或mRECIST评估的肿瘤反应相关。这些结果通过倾向评分匹配和逆概率处理加权调整数据集得到进一步验证。结论：较高的肝脏肿瘤负荷与LM-GEP-NETs患者较差的OS相关。TAE后的肿瘤反应提示生存获益。早期TAE（诊断后4个月内）与更好的治疗反应相关。

原文链接：

Trans-Arterial Embolization for Liver Metastases of Gastroenteropancreatic Neuroendocrine Tumors: Response Indicates Survival Benefit?