TREATMENT OF METASTATIC CARCINOID-TUMORS USING MULTIMODALITY THERAPY OF OCTREOTIDE ACETATE INTRAARTERIAL CHEMOTHERAPY, AND HEPATIC ARTERIALCHEMOEMBOLIZATION

BACKGROUND: Overall survival and quality of life in patients with meta static carcinoid tumors depend on control of tumor growth and suppress ion of amine-induced symptoms. METHODS: We report on a series of 10 pa tients with carcinoid tumors metastatic to the liver who were treated with long-term octreotide acetate therapy (100 to 500 mu g three times a day), sequential intra-arterial 5-fluorouracil (5-FU) infusions, an d hepatic tumor chemoembolization. RESULTS: All 10 patients remained a symptomatic or had extremely mild symptoms after combined modality the rapy (mean follow-up duration of 51.5 months), Sixty percent of the pa tients had a >50% reduction of their tumor size (mean duration 42 mont hs). An additional 30% experienced stabilization of tumor growth for 6 months or longer. Five of the 10 patients are currently alive. The me an group survival is 58 months since diagnosis (range 33 to 115) and 4 0 months since starting therapy (range 12 to 65). CONCLUSIONS: Combini ng octreotide acetate, intra-arterial 5-FU, and tumor chemoembolizatio n effectively retards tumor growth while providing excellent symptom c ontrol.