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J Clin Endocrinol Metab. 2006 Jul;91(7):2496-9. Epub 2006 Apr 11.

Chemoembolization for liver metastases from medullary thyroid carcinoma.

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1
Institut Gustave Roussy, rue Camille Desmoulins, 94805 Villejuif Cedex, France.

Abstract

BACKGROUND:

Medullary thyroid carcinoma (MTC) is a well-differentiated neuroendocrine tumor. Distant metastases are the main cause of cancer-related death. Systemic chemotherapy produces only rare tumor responses. Somatostatin analogs and other available modalities are poorly effective to control symptoms.

AIMS:

The aim of our study was to evaluate the impact of liver transarterial chemoembolization (TACE) in MTC patients with predominant and progressive liver metastases.

PATIENTS AND METHODS:

Twelve MTC patients underwent 18 TACE courses (mean, 1.5; range, 1-2). Response evaluation criteria in solid tumors were used to evaluate tumor responses. Symptomatic responses were defined by more than a 25% decrease of symptoms intensity.

RESULTS:

Partial radiological tumor response was obtained in five patients (42%) with a median duration of 17 months (mean, 19; range, 15-28 months), stabilization in five (42%) with a median duration of 24 months (mean, 24; range, 4-39 months), and progression in the remaining two (16%). The five partial tumor responses were observed in the nine patients with less than 30% liver involvement. Clinical response was observed in two of the five patients with diarrhea. Carcinoembryonic antigen did not appear to be a useful marker in this setting. Significant grade 3-4 toxicity was observed in one patient who had a major tumor necrosis after TACE.

CONCLUSION:

TACE should be considered for treating MTC patients with progressive and predominant liver metastasis, and preferably at an early stage during the course of metastatic disease.

PMID:
16608897
DOI:
10.1210/jc.2005-2401
[Indexed for MEDLINE]
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