Selective hepatic arterial chemoembolization for liver metastases in patients with carcinoid tumor or islet cell carcinoma

In many patients with liver metastases from islet cell or carcinoid tumor, vascular occlusion therapy results in prolonged control of symptoms, bioche mical response, and also tumor regression. Chemotherapy agents were added t o evaluate safety and efficacy. Thirty patients with liver metastases from either carcinoid tumor or islet cell carcinoma underwent sequential vascula r occlusion therapy combined with chemotherapeutic agents. In patients with carcinoid tumor a combination of cisplatin (150 mg) and doxorubicin (50 mg ) was used in patients with islet cell carcinoma, a combination of 5-florou racil (350 mg) and streptozotocin (1000-2000 mg) was used. Sixteen patients had carcinoid tumor and 14 had islet cell carcinoma. Biochemical response was observed in 12 of 16 (75%) carcinoid patients and 9 of 10 (90%) islet c ell patients. The overall partial response rate was 37% (11/30 patients). P artial response occurred in 4 of 16 (25%) patients with carcinoid tumor and 7 of 14 (50%) with islet cell carcinoma. The median duration of partial re sponses was 24 months (range, 6-63+ months). The median survival of all pat ients was 15 months (range, 2-67+ months). No treatment-related deaths occu rred. Our data suggest that the addition of these chemotherapeutic agents t o vascular occlusion, although safe, has no additional benefit.