Purpose

To assess the safety and effectiveness of transarterial radioembolization (TARE) in the treatment of hepatic metastases from pancreatic ductal adenocarcinoma (PDAC).

Materials and Methods

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.

Results

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.

Conclusions

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.

中文翻译：

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经动脉放射栓塞治疗胰腺癌肝转移：系统评价

 目的

评估经动脉放射栓塞（TARE）治疗胰腺导管腺癌（PDAC）肝转移的安全性和有效性。

 材料和方法

使用与 TARE 和 PDAC 肝转移相关的关键词和医学主题词术语对 Embase 和 MEDLINE 数据库进行系统搜索。报告包括 TARE 后总生存期 (OS)、肝无进展生存期 (hPFS) 或肿瘤反应的观察性研究和临床试验。

 结果

八项研究符合纳入标准，涉及 145 名转移性 PDAC 患者。未发现随机对照试验，有 4 项研究是前瞻性的。 44 名患者 (30.3%) 既往接受过胰腺切除术，66 名患者 (45.5%) 在 TARE 时出现肝外转移。大多数研究 (n = 6) 使用树脂微球进行去皮。中位 3 个月的汇总疾病控制率为 69.4%。自 TARE 起的中位 OS 范围为 3.7 至 9 个月。中位 hPFS 范围为 2.4 至 5.2 个月。共有 31 例 3-4 级生化毒性和 4 例与治疗相关的死亡。

 结论

由于患者数量少、前瞻性数据有限以及研究设计的异质性，TARE 在 PDAC 肝转移患者中的作用仍不清楚。需要进一步的前瞻性研究来评估 TARE 在精心挑选的仅肝转移性疾病患者中的作用。