Hepatic artery radioembolization (HARE) in the management of progressive metastatic neuroendocrine tumors (NETs): A survival and biochemical response analysis in geriatric (G) and young (Y) populations.

e19727 Background: HARE with Y-90 SIR-Spheres is a treatment (Rx) option for NET patients (pts); however, survival statistics, biochemical responses (BR) and factors influencing outcomes are lacking. The objectives of this study are: 1) to determine whether age (G ≥ 60yrs vs Y< 60yrs) influences overall survival (OS) and progression free survival (PFS); 2) to calculate biochemical response (BR); 3) to identify predictive factors in NET pts receiving HARE. METHODS A retrospective chart analysis of consecutive HARE NET pts at Ochsner Medical Center Kenner was performed. Demographic, serial pre- and post-Rx (1,6,12,18 mos) Karnofsky performance status (KPS), biochemical (5-HIAA, chromogranin A, pancreastatin, neurokinin A [NKA]) and radiographic response data were collected and OS, PFS and BR calculated. RESULTS Between 12/2004 and 8/2010, 73 NET pts (37 small bowel [SB], 12 pancreas [P], 6 rectum, 18 other) with a median age (range) of 60.4 yrs (39-75) underwent HARE. Survivals statistics are shown in the table. No differences in OS (p=0.759) and PFS (p=0.767) were seen in G vs Y pts. Primary site was not associated with OS (p=0.373), SB had better PFS (p<0.001). Higher Ki-67 index had lower PFS, Hazard ratio (HR)=1,488,691, p=0.002. NKA level at 6 mos was directly proportional to radiographic progression, HR=1.05, p=0.047. Pre-Rx KPS was greater for alive pts, median KPS=85 vs median KPS=72 for pts who died, p=0.040. CONCLUSIONS HARE is equally effective in all age groups and is independent of primary site. SB primary has a greater PFS than P. The Ki-67 index is inversely proportional to PFS. Higher pre-Rx KPS correlates with better outcomes. NKA level at 6 mos is predictive of progressive disease. [Table: see text].