TRANSCATHETER CHEMOEMBOLIZATION OF PROGRESSIVE CARCINOID LIVER METASTASIS

PURPOSE: The authors report their experience treating progressive live r metabases from carcinoid tumor with doxorubicin, iodized oil, and ge latin sponge embolization. MATERIALS AND METHODS: Of 23 patients, 18 h ad carcinoid syndrome and 19 had elevated urinary 5-hydroxyindoleaceti c acid (5-HIAA) levels. Relief of symptoms, changes in 5-HIAA levels, and changes in tumor size could be evaluated in 10, 11, and 17 patient s, respectively. RESULTS: Symptomatic response was complete (average d uration, 29 months) in 70% and partial in 30% of evaluated patients. B iologic response was complete (average duration, 21 months) in 73%, pa rtial in 18%, and minor in 9% of evaluated patients. Morphologic respo nse was complete in 11%, partial in 24%, and minor in 24% of evaluated patients. Survival after diagnosis of primary tumor, diagnosis of hep atic metastases, and first chemoembolization was 81, 47, and 24 months , respectively. Eight patients were alive at the end of the study. No mortality was related to chemoembolization. CONCLUSION. Chemoembolizat ion is safe and effective for palliation of carcinoid liver metastases .