Hepatic artery embolization (HAE) has been utilized for the treatment of advanced hepatic carcinoid metastases. This has shown promising symptom palliation and tumor control.
Researchers from the University of Florida College of Medicine, Florida, USA, examined symptom control, quality-of-life, octreotide dependence, and tumor progression in 24 patients (11 male, 13 female, mean age 60).
These patients had carcinoid and unresectable hepatic metastases, confirmed by urinary 5-hydroxyindole acetic acid (5-HIAA) measurement and biopsy.
They were treated with Lipiodol/Gelfoam HAE from 1993 to 2001.
| Hepatic metastases remained stable in 17% of patients and decreased in 79%.|
|Journal of Gastrointestinal Surgery|
The median follow-up was 35 months.
The research team found that before HAE, 58% of patients had malignant carcinoid syndrome.
Their symptoms were quantified using the team's previously reported Carcinoid Symptom Severity Score.
It was also found that 54% of patients required octreotide for symptom palliation.
Following treatment, symptom severity, octreotide dose, and tumor response were measured.
In this study, asymptomatic patients did not develop symptoms or require following treatment.
The team discovered that hepatic metastases remained stable in 17% of patients, and decreased in 79%.
They also determined that mean pretreatment Symptom Severity Scores decreased post-treatment, with 64% of patients becoming asymptomatic.
Furthermore, mean pretreatment octreotide dosages also decreased, with 46% of patients discontinuing the drug.
There were no treatment-related serious complications or deaths.
Dr Scott Schell's team concluded, "This study demonstrates that Lipiodol/Gelfoam HAE produces excellent control of malignant carcinoid syndrome, allowing patients to decrease or eliminate use of octreotide, while controlling hepatic tumor burden".