Background: Medullary thyroid carcinoma (MTC) is a well differentiated neuro-endocrine tumor. Distant metastases are the main cause of cancer related death. Systemic chemotherapy produces only rare tumor responses. Somatostatin analogs and other available modalities are poorly effective to control symptoms.

Aims: The aim of our study was to evaluate the impact of liver transarterial chemoembolization (TACE) in MTC patients with predominant and progressive liver metastases.

Patients and Methods: Twelve MTC patients underwent 18 TACE courses (mean 1.5, range: 1-2). RECIST criteria were used to evaluate tumor responses. Symptomatic responses were defined by more than a 25% decrease of symptoms intensity.

Results: Partial radiologic tumor response was obtained in 5 patients (42%) with a median duration of 17 months (mean: 19, range: 15-28 months), stabilization in 5 (42%) with a median duration of 24 months (mean: 24, range: 4-39 months), and progression in the remaining 2 (16%). The 5 partial tumor responses were observed in the 9 patients with less than 30% liver involvement. Clinical response was observed in 2 of the 5 patients with diarrhea. CEA did not appear to be a useful marker in this setting. Significant grade 3-4 toxicity was observed in 1 patient who had a major tumor necrosis following TACE.

Conclusion: TACE should be considered for treating MTC patients with progressive and predominant liver metastasis, and preferably at an early stage during the course of metastatic disease.