Splenomegaly and Tumor Marker Response Following Selective Internal Radiation Therapy for Non-Resectable Liver Metastases from Neuroendocrine Tumor

PURPOSE:The aim of this study was to investigate changes in spleen size, the level of chromogranin Aas a tumor marker, and the relationship between these two parameters before and 3 months after selectiveinternal radiation therapy (SIRT) for non-resectable liver metastases from neuroendocrine tumor (NET).Our first serious adverse event with this relatively new treatment is also discussed.METHODS:A retrospective review of a prospective database identified patients with non-resectable livermetastases from NET who underwent SIRT between 2003 and 2007. Patients who underwent CT scansbefore and 3 months after treatment were included. The patients were divided into two groups:those withand without a 20 % or more increase in splenic volume on the CT scans. The percentages of patients showinga tumor marker response in the two groups were then comparedRESULTS:Fourteen patients were included in the present analysis. A tumor marker response was seenin 6 of 7 patients( 85.7%) who showed an increase in splenic volume of>20%, and in 3 of 7 patients( 42.9%) without an increase in splenic volume (p=0.266). There was one death as a result of oesophageal varicealbleeding due to portal hypertension at 9 months after treatment.CONCLUSION:Splenic enlargement after SIRT may be associated with tumor marker response, althoughthis could not be confirmed statistically in this study due to the small number of patients. Long-termsplenomegaly and portal hypertension may be important complications of SIRT. This issue needs to be investigatedfurther using a larger number of patients and longer follow-up

Consumer Spirituality and Marketing

Consumer Spirituality and Marketing Sudhir Kale, Bond University, Australia Over the last ten years, the topic of spirituality has inspired scores of studies in management and related disciplines. Marketing scholars, it seems, have shied away from discussing spirituality for far too long. This paper draws attention to the rising salience of consumers' spiritual needs. A working definition of spirituality and preliminary guidelines for researchers are provided to kickstart research and dialogue in this important area. It is argued that spiritual utility urgently needs to be incorporated along with other utilities when considering product benefits. [to cite]