Metastatic Hepaitic Neuroendocrine Tumors :Correlation Of CT Findings With Pathology And The Safety And Effectiveness Of Modified TACE

Part1 Metastatic hepatic neuroendocrine tumors : correlation of CT findings with pathologic classificationObjectiveTo investigate the correlattion of 3-phase enhanced computed tomographic(CT)findings of metastatic hepatic neuroendocrine tumors with pathologic classification and the relationship between tumors' enhancement patterns and size.MethodsFrom Jan.2000 to Jan.2016,49 patients with pathologically proven neuroendocrine tumors metastased to liver were enrolled in this study.All patients received 3-phase enhanced CT scaning.CT findings were retrospectively reviewed for morphologic(ie,size,number,location,margin,vascular invasion)study.The correlattion of CT features of metastatic hepatic neuroendocrine tumors with pathologic classification and the relationship between tumors' enhancement patterns and size were evaluated.ResultsThe morphologic patterns were variable regardless of the pathologic diagnoses.For the enhancement pattern,12 patients had obvious enhancing in arterial phase and wash-out in delay phase,and 37 patients had obvious enhancing in both arterial and delay phase without certain correlation between the enhancement pattern and pathologic diagnoses,but the enhanced patterns is correlated with tumors' size.ConclusionThe CT features of neuroendocrine tumors with live metastases were variable and do not correlate with their pathologic classification.However,tumors' enhanced patterns correlate with tumors' size.Part2 Safety and effectiveness of transhepatic arterial chemoembolization combined with pumping of oxaliplatin in the treatment of metastatic hepatic neuroendocrine tumors:a one-armed retrospective studyObjective To evaluate the safety and the effectiveness of modified TACE for treatment of metastatic hepatic neuroendocrine tumorsMethods A retrospective analysis of the clinical data of 24 patients with metastatic hepatic neuroendocrine tumors in our hospital from Jan.2000 to Jan.2016 were carried out.The diagnosis for all patients were confirmed by biopsy or surgery.Every patients were received the at least twice modified TACE(after arterial infusion of several mlililitres of mixture of Lipiodol with oxaliplatin,100~120 mg of oxaliplatin was slowly perfused through indwelling catheter for one hour).The metastases were examined with enhanced CT or MRI every 4 weeks.Adverse events based on CTCAE V4.03 and progression-free survival(PFS)were evaluated.The objective response rate was evaluated in accordance with m RECIST.SPSS 23.0 was used for analysis by Kaplan-Meier method.Results All patients received a total number of 166 times of modified TACE.The adverse events mainly included fever(Level?140,84.3%,Level?26,15.7%),vomiting(Level?134,80.7%,Level?32,19.3%),pain(Level?45,27.1%,Level?115,69.3%,? 6,3.6%),local hematoma(4 cases),transaminase elevation.Most of them were at level1-2without treatment related death.The objective response rate is 62.5% including PR in15(62.5%);SD in 6(25%),PD in 3(12.5%).The median PFS was 44.0months(95%CI,19.52-68.49).Conclusion The modified TACE is practically effective in treating metastatic hepatic neuroendocrine tumors.Compared to traditional TACE,it can rechieved relatively higher objective response rate with torerable adverse reactions.