Safety and efficacy of transarterial embolization combined with octreotide LAR on reducing tumor burden for neuroendocrine tumor liver metastasis

Objective To evaluate the tumor burden reducing efficacy and safety of transcatheter arterial embolization (TAE) combined with octreotide LAR on neuroendocrine tumor liver metastasis (NETLM). Methods Twenty-nine NETLM patients treated in the First Affiliated Hospital of Sun Yat-sen University from October 2014 to August 2018 were retrospectively recruited, including 12 males and 17 females. The mean age was 25-69(50±11) years. All patients were histologically proved as well-differentiated NET liver metastasis. Seventeen patients underwent combined treatment of TAE plus octreotide LAR (combined group) and 12 patients treated with only octreotide LAR (control group). Response of hepatic lesions were assessed according to RECIST 1.1. Objective response rates (ORR) of two groups were compared and analyzed. Safety and tolerance to TAE were also evaluated. Results There were 13 PR and 4 SD in combined group, but only 1 PR and 9 PD in the control group. The ORR between the two groups were significantly different (13/17 vs 1/12, P<0.01).The main complication post TAE was post embolization syndrome, including abdominal pain (12/17), vomiting (6/17), fever (4/17), elevated transaminase (8/17) and bilirubinemia (3/17). Tumor lysis syndrome was observed in one patient. Conclusion Compared to administration of octreotide LAR, TAE combined with octreotide LAR can effectively reduce tumor burden in patients with NETLM. TAE is safe and well-tolerated. Key words: Embolization, therapeutic; Liver neoplasms; Neoplasm metastasis; Neuroendocrine tumors