Endocrine Abstracts

Introduction/Background: 16^th May 2024 NICE confirmed use of Selective Internal Radiation Therapy (SIRT) for neuroendocrine tumours that have metastasised to the liver, with arrangements in place for clinical governance, consent and audit. This was subject to Commissioners/providers implementing the guidance. Trans Arterial Embolisation (TAE) and Trans Arterial Chemo Embolisation (TACE) are two of the comparative therapies that the committee examined to come to their conclusion. The NET community is awaiting details on the commissioning of SIRT.

Aim: To examine the process and outcome of patients undergoing TAE at QEHB, looking at length of stay, complications, long term outcomes and compare this to the limited number of our patients receiving SIRT.

Method and Material: Experience of SIRT for NET at QEHB has been limited due to a lack of funding from the Commissioners. There have been 4 SIRT for NET in 2019 to 2023. In comparison there have been 20 TAE for NET from 2018 to 2023. Trust authority for the audit was obtained and retrospective analysis of hospital records was undertaken. The number of patients who had undergone TAE/SIRT for metastatic NET was ascertained. Further data was collected to enable discussion of the treatments and make comparisons. This data included demographics, rationale for treatment, disease burden, complications, length of hospital stay and survival.

Results/Discussion: From our series it appears that TAE is a procedure that can entail a hospital inpatient stay of several days and involve post procedure complications. The limited experience of SIRT demonstrated a shorter inpatient stay and fewer complications. With such small numbers however, it is difficult to infer any difference in survival.

Conclusion: The literature on SIRT and our own hospital experience with TAE suggest a different treatment journey. When looking at the allocation of hospital resources it would be helpful to calculate the difference in costings. However, it is difficult to do this as the costs of the therapeutic agent are commercially sensitive. The impact that SIRT will have on the provision of TAE in the future in uncertain.