Transarterial Radioembolization for Hepatic Metastases of Pancreatic Adenocarcinoma: A Systematic Review

• Published in: Journal of vascular and interventional radiology Vol. 33; no. 12; pp. 1559 - 1569.e2
• Main Authors: Alexander, Harry C., Nguyen, Cindy H., Chu, Michael J.J., Tarr, Gregory P., Han, Catherine H., Thomas, Robert H., Holden, Andrew H., Bartlett, Adam S.J.R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022
• Subjects: Adenocarcinoma - therapy; Carcinoma, Hepatocellular - therapy; Carcinoma, Pancreatic Ductal; Embolization, Therapeutic - adverse effects; Humans; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Liver Neoplasms - radiotherapy; Pancreatic Neoplasms - pathology; Retrospective Studies; Treatment Outcome; Yttrium Radioisotopes - adverse effects; CT; CTCAE; DCR; NOS; PDAC; 5FU; OS; hPFS; ECOG; TARE
• ISSN: 1051-0443; 1535-7732; 1535-7732
• DOI: 10.1016/j.jvir.2022.08.031

To assess the safety and effectiveness of transarterial radioembolization (TARE) in the treatment of hepatic metastases from pancreatic ductal adenocarcinoma (PDAC). A systematic search of the Embase and MEDLINE databases was conducted using keywords and Medical Subject Headings terms related to TARE and hepatic metastases from PDAC. Observational studies and clinical trials reporting overall survival (OS), hepatic progression-free survival (hPFS), or tumor response after TARE were included. Eight studies, comprising 145 patients with metastatic PDAC, met the inclusion criteria. No randomized controlled trials were identified, and 4 studies were prospective. Forty-four (30.3%) patients underwent previous pancreatic resection, and 66 (45.5%) had extrahepatic metastases at the time of TARE. Most studies (n = 6) used resin microspheres for TARE. The pooled disease control rate was 69.4% at a median of 3 months. The median OS from the time of TARE ranged from 3.7 to 9 months. The median hPFS ranged from 2.4 to 5.2 months. There were 31 Grade 3–4 biochemical toxicities and 4 treatment-related deaths. The role of TARE in patients with hepatic metastases from PDAC remains unclear owing to low patient numbers, limited prospective data, and heterogeneity in the study design. Further prospective studies are required to evaluate the role of TARE in carefully selected patients with liver-only metastatic disease.