期刊
JOURNAL OF NUCLEAR MEDICINE
卷 55, 期 3, 页码 360-366出版社
SOC NUCLEAR MEDICINE INC
DOI: 10.2967/jnumed.113.127662
关键词
liver malignancies; repeated radioembolization; Y-90 microspheres; sequential approach; toxicity
资金
- University of Magdeburg
- SIRTEX Medical
The purpose of this study was to assess the safety of repeated Y-90 radioembolization with resin microspheres in patients with extensive primary and secondary liver tumors after failure of first radioembolization. Methods: Between 2007 and 2011, 21 patients (12 women, 9 men; mean age, 61.0 y) with nonresectable advanced liver tumors (breast cancer liver metastases, n = 7; colorectal liver metastases, n = 5; hepatocellular carcinoma, n = 8; cholangiocellular carcinoma, n = 1) were repeatedly treated by radioembolization. Safety was the primary endpoint. Whole-liver treatment was achieved with sequential treatment sessions in most patients, with selective embolization of the left and right liver lobes within 6 wk. Toxicity was documented prospectively and according to Common Terminology Criteria for Adverse Events 4.0 criteria based on laboratory parameters; magnetic-resonance tomography; and clinical examinations 3 d, 6 wk, and every 3 mo after selective internal radiotherapy (SIRT). Metric variables were evaluated using the Student t test. Overall survival was assessed by Kaplan-Meier statistics. Results: Patients received an average of 1.6 whole-liver treatments performed in 3.0 unilobar radioembolizations (liver lobes sequentially). The mean total activity administered was 2.57 GBq. No radioembolization-induced liver disease was observed in any of the patients. Three patients showed reversible grade III to IV toxicities according to laboratory values, which returned to pretreatment levels after 6 wk. In 1 patient, a treatment-related duodenal ulcer occurred. Median overall survival was 18 mo after first radioembolization. Conclusion: In advanced liver tumors, repeated whole-liver treatments with Y-90 radioembolization can be performed with an acceptable toxicity profile.
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