Internal Radiation Therapy in Treating Patients With Liver Metastases From Neuroendocrine Tumors

You may be eligible if

• DISEASE CHARACTERISTICS:
• Pathologically confirmed neuroendocrine tumor metastatic to the liver
• * Well-differentiated or moderately well-differentiated neuroendocrine tumors
• Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm with conventional techniques or ≥ 10 mm with spiral CT scan
• Symptomatic disease, meeting one of the following criteria:
• * Refractory carcinoid symptoms, defined as Carcinoid Symptom Severity scale \> 2 despite use of octreotide acetate at ≥ 200 mcg subcutaneously three times daily (or 20 mg intramuscularly once monthly) for ≥ 4 weeks
• * Evidence of radiographic progression with either of the following manifestations:
• * Moderate-severe right upper quadrant pain and unintentional weight loss \> 10%
• * Decline in Karnofsky performance status \> 10 points
• At least a 20% increase in the sum of the longest diameters of target lesions in the liver within the past 12 months
• No more than 75% replacement of normal liver by neuroendocrine tumor
• No more than 20% arteriovenous lung shunting on a technetium Tc 99m macro-aggregated albumin nuclear scan
• No equivocal, nonmeasurable, or nonevaluable liver metastasis
• PATIENT CHARACTERISTICS:
• Karnofsky performance status 50-100%
• Life expectancy ≥ 6 months
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Creatinine ≤ 1.5 mg/dL
• Bilirubin ≤ 2.0 mg/dL
• Albumin ≥ 3.0 g/dL
• Absolute granulocyte count ≥ 1,500/mm³
• Platelet count ≥ 65,000/mm³
• Hemoglobin \> 9.0 g/dL
• INR ≤ 1.4
• No hepatic arterial anatomy that would preclude the administration of study treatment into the liver
• No nonmalignant disease that would preclude study participation
• No other malignancy within the past 5 years except for cured basal cell carcinoma of the skin or cured carcinoma in situ of the uterine cervix
• PRIOR CONCURRENT THERAPY:
• Prior surgery, chemotherapy, or locally ablative technique for the liver cancer allowed
• No prior radiotherapy to the upper abdomen that includes the liver in the treatment field
• No investigational drug or agent/procedure (i.e., participation in another clinical trial) within the past 4 weeks
• No other specific anticancer treatment (other than octreotide acetate) during and for 3 months after completion of study therapy