D Briol, A Ceratti, R Lhommel, L Annet, C Dragean, E Danse, P Trefois, M Van Den Eynde, A De Cuyper, P Goffette, I Borbath
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引用次数: 0
摘要
背景和研究目的：选择性内放射治疗（SIRT）对神经内分泌肿瘤（NELM）不可切除的肝转移瘤效果良好，疾病控制率（DCR）较高。本研究旨在回顾性评估SIRT治疗神经内分泌肿瘤10年的疗效和安全性：主要终点是2、4和12个月（m）时的客观反应率（ORR）和RECIST 1.1标准的DCR。次要终点为总生存期（OS）、无肝进展生存期（liver-PFS）、临床反应（NEN相关症状改善）和安全性：结果：2011年至2021年，一个中心连续收治了50例接受SIRT治疗的NELM患者。NEN的两个主要原发部位是胰腺（46%）和小肠（36%）。组织学NEN分级为1级、2级和3级的比例分别为10%、46%和44%。2米时的ORR和DCR分别为16%和80%，4米时分别为22%和92%，12米时分别为32%和82%。1年和2年的存活率分别为76%和72%。OS和肝脏-PFS的预后因素为NEN组织学分级（3 vs 1+2）（OS的危险比（HR）为4.33 [1.8-10.8]：4.33[1.8-10.6]，肝脏-生存期：3.91[1.3-11.4]），以及早期（2米）DCR（OS的危险比（HR）：0.14[0.1-0.4]，肝脏-生存期：0.016[0.003-0.08]）。10 名无症状患者中有 7 人出现临床反应。一名患者死于放射性栓塞引起的肝病：结论：SIRT对NELM患者有疗效，DCR高，安全性好。G1-2级和早期DCR与较好的OS和肝脏PFS相关。
Selective internal radiation therapy for neuroendocrine liver metastases: efficacy, safety and prognostic factors. A retrospective single institution study.
Background and study aims: Selective internal radiation therapy (SIRT) has shown good results in unresectable liver metastases from neuroendocrine neoplasms (NELM) with a high disease control rate (DCR) reported. The aims of the study is to assess retrospectively the efficacy and safety of 10y of SIRT for NELM.
Patients and methods: Primary endpoint was objective response rate (ORR) and DCR by RECIST 1.1 at 2, 4 and 12 months (m). Secondary endpoints were overall survival (OS), liver progressionfree survival (liver-PFS), clinical response (NEN-related symptoms improvement) and safety.
Results: 50 consecutive patients with NELM who got SIRT from 2011 to 2021 in one center. The two major NEN primary sites were pancreas (46%) and small intestine (36%). Histological NEN grades were 10%, 46% and 44% for grades 1, 2 and 3 respectively. ORR and DCR were 16% and 80% at 2m, 22% and 92% at 4m and 32% and 82% at 12m. Survival rates at 1 and 2 y were 76% and 72% respectively. Prognostic factors for OS and liver-PFS were NEN histological grade (3 vs 1+2) (hazard ratio (HR) for OS: 4.33 [1.8-10.6], for liver-PFS: 3.91 [1.3-11.4]), and early (2m) DCR (HR for OS: 0.14 [0.1-0.4], for liver-PFS: 0.016 [0.003-0.08]). Clinical response occurred in 7 of the 10 symptomatic patients. One patient died from radioembolization-induced liver disease.
Conclusion: SIRT showed efficacy in NELM pts, with a high DCR and an good safety profile. G1-2 grade and early DCR were associated with a better OS and liver-PFS.
期刊介绍：
The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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