After embolization, patients were monitored in the hospital and d

After embolization, patients were monitored in the hospital and discharged find more only after their liver enzymes had peaked. All patients were prophylactically administered antibiotics for one week in order to prevent abscess formation. Intravenous narcotics were typically administered for pain control. In case of recurrence or progression, TAE procedure can be performed several times [39]. When proximal embolization of tumor-feeding arteries in hepatic metastases was performed

major effectiveness is remarked. Individual embolizations were spaced approximately 4 weeks apart and the majority of patients completed their embolizations in 2 or 3 times [9, 40, 41]. Efficacy Many reviews have been published on loco-regional ablative treatments of liver metastases of NENs. Several studies have been reported on TACE, while only ARS-1620 chemical structure few studies on TAE. This review focuses on TAE performance and safety in patients with liver metastases of NENs. It has to be highlighted that many authors did not report data on clinical response to TAE or reported these data as indirect consequence of decrease of tumour markers. As a whole, 896 patients with NEN and liver metastases have been treated for a total of 979 TAE procedures. Median survival rates ranged from 10 to 80 EX 527 cost months [9, 21, 35, 39, 42–52], but in the most of studies it

was between 35 and 60 months (Table  1). Survival was reported to be correlated to objective tumor response. Progression free survival ranged from 0 to 60 months. Objective tumour response, including partial and complete response, was 50% as average (range, 2-100%). If we consider both tumour response and stabilization of tumor growth, the rate of patients who received a benefit from TAE was about 40% [9, 21, 35, 39, 42–52] (Table  1). Clinical response was about 56% (range, 9-100%). As far as biochemical response is concerned, TAE was reported to be effective in reducing biochemical markers in >50%

of patients with NEN. In NEN patients with carcinoid syndrome, major decreases in 5-HIAA levels (>50% decrease as compared to baseline) occured in a range of 11-100% [9, 35, 39, 42–44, 51, 53–57] (Table  2). Table 1 Tumour response and survival rate in patients treated with Transarterial Embolization (TAE) Paper Number and type of NEN Number of TAEs TR OS Loewe et al. 2003[7] 23 carcinoids 75 TAE 4 (18%) CR, Non-specific serine/threonine protein kinase 12 (55%) PR, 6 (27%) PD 69 months   (22 pts evaluable)   Gupta et al. 2003[18] 69 carcinoids Carcinoids: Carcinoids: 46 (67%) PR, 6 (8.5%) MR, 11 (16%) SD, 6 (8.5%) PD 18 months   54 PNENs 42 TAE/27 TACE PNEN: 19 (35%) PR, 1 (2%) MR, 32 (59%) SD, 2 (4%) PD     PNENs:     32 TAE/22 TACE   Carrasco et al. 1986[32] 25 carcinoids 25 TAE 20 (87%) CR, 1 (5%) PD 11 months   (23 evaluable)   Strosberg et al. 2006[36] 59 carcinoids 161 TAE 23 pts evaluable: 11 (48%) PR, 12 (52%) SD 36 months   20 PNENs     5 unspecified NENs   Hanssen et al. 1989[39] 19 carcinoids (7 evaluable) 7 TAE 7 (100%) PR 12 months Wangberg et al.

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