TACE For The Treatment Of Hepatic Metastases From Pancreatic Neuroendocrine Neoplasms:Imaging Features Analysis And Clinical Observation

Part 1 Imaging features analysis of hepatic metastasis from pancreatic neuroendocrine neoplasms before and after transcatheter arterial chemoembolization treatmentObjectives:To investigate the imaging manifetations of magnetic resonance(MR)of hepatic metastasis from pancreatic neuroendocrine neoplasms before and after transcatheter arterial chemoembolization(Modified TACE)treatment.Methods:We retrospectively evaluated the MR imaging data of twelve patients with hepatic metastasis of pancreatic neuroendocrine neoplasms(PNEN)confirmed by pathology which were treated with Modified TACE.They were divided different groups according to different positions,interval sizes and enhancement methods,and the effective rates were compared after Modified TACE treatment.Results:All of the twelve cases were multiple and round,including 60 lesions with 39 in right lobe and 21 in left lobe.There were divided into four groups according to the criteria of maximum diameter of the lesion,group A:1～2cm(n=16),group B:2-3cm(n=29),group C:3～4cm(n=10),and group D:more than 4cm(n=5).The numbers of circular and solid enhancement were 37 and 23 respectively.The total effective rate of TACE was 61.6%.Chi-square test showed that there was no significant difference in the proportion of left and right lobes and intensification types,but there were differences in the curative effect.Conclusion:MR can well display the imaging manifestations of hepatic metastasis of PNEN before and after Modified TACE treatment,which is very useful for promptly and effectively evaluating the therapeutic efficacy of Modified TACE.Part 2 Transcatheter arterial chemoembolization for the treatment of hepatic metastases from pancreatic neuroendocrine neoplasms:the clinical observationObjectives:To evaluate the curative efficacy of transcatheter arterial chemoembolization(Modified TACE)in the treatment of hepatic metastases from pancreatic neuroendocrine neoplasms(PNEN).Methods:The clinical data of 25 patients with surgically or pathologically proved hepatic metastases from PNEN,who had received Modified TACE,were retrospectively analyzed.A total of 87 Modified TACE procedures were performed.The effective rates were evaluated by magnetic resonance imaging(MR1),and the progression-free survival time(PFS),total survival time(OS)and complications were analyzed.Results:The interventional therapy was successfully accomplished in all the 25 patients.The MRI evaluation of the curative effect showed that showed that CR(complete remisson)was obtained in 0 patient,PR(partial remisson)in 15 patients.SD(stable disease)in 4 patients,and PD(progressive disease)in 6 patients.The total effective rate was 60%.The median PFS was 13 months and median OS was 18 months.No serious complications occurred in all patients except for one patient who developed pseudoaneurysm during operation.Conclusion:For the treatment of patients with inoperable hepatic metastases from PNEN,Modified TACE is a safe and effective as a local therapy,which can be used as an effective supplement to systemic therapy.