188Re-HDD/lipiodol therapy for hepatocellular carcinoma: an activity escalation study View Full Text


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Article Info

DATE

2005-12-07

AUTHORS

Bieke Lambert, Klaus Bacher, Luc Defreyne, Hans Van Vlierberghe, Jae Min Jeong, Rong Fu Wang, Jan van Meerbeeck, Peter Smeets, Roberto Troisi, Hubert Thierens, Filip De Vos, Christophe Van de Wiele

ABSTRACT

PurposeThe aim of this study was to investigate the feasibility of administering increasing activities of 188Re-4-hexadecyl-1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol/lipiodol (188Re-HDD/lipiodol) for the treatment of hepatocellular carcinoma (HCC) in patients with well-compensated cirrhosis.MethodsThe activity levels were increased by 1.1 GBq/step after a 6-week interval without unacceptable adverse events in at least five consecutive patients. Absorbed doses to the various organs were calculated according to the MIRD formalism, based on three gamma-scintigraphic studies. Response was assessed by means of MRI and alpha-fetoprotein (AFP) monitoring.ResultsThirty-five treatments were carried out in 28 patients. Activities from 4.8 to 7.0 GBq 188Re-HDD/lipiodol were administered via a transfemoral catheter. The mean absorbed dose to the liver (including tumour) was 7.6±2.2, 9.8±4.9 and 15.2±4.9 Gy for the 4.8-, 5.9- and 7.0-GBq groups, respectively. Treatment was well tolerated at all activity levels. Further escalation of the administered activity was not feasible owing to limitations related to the radiolabelling procedure. Response assessment on MRI showed partial response, stable disease and disease progression in 1, 28 and 2 assessable treatments, respectively. In 8 of 17 treatment sessions with an initially elevated AFP, a reduction ranging from 19% to 97% was observed 6 weeks later.ConclusionFollowing the intra-arterial administration of 4.8–7.0 GBq 188Re-HDD/lipiodol in patients with HCC and well-compensated liver cirrhosis, no severe adverse events occurred. Further escalation was not feasible owing to limitations in the radiolabelling procedure. More... »

PAGES

344-352

References to SciGraph publications

  • 2003-11-19. Preliminary results of transarterial rhenium-188 HDD lipiodol in the treatment of inoperable primary hepatocellular carcinoma in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2001-05-01. Hepatocellular carcinoma in BRITISH JOURNAL OF CANCER
  • 2003-12-23. Development and biodistribution of 188Re-SSS lipiodol following injection into the hepatic artery of healthy pigs in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00259-005-1954-1

    DOI

    http://dx.doi.org/10.1007/s00259-005-1954-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1050009698

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/16333675


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    29 schema:description PurposeThe aim of this study was to investigate the feasibility of administering increasing activities of 188Re-4-hexadecyl-1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol/lipiodol (188Re-HDD/lipiodol) for the treatment of hepatocellular carcinoma (HCC) in patients with well-compensated cirrhosis.MethodsThe activity levels were increased by 1.1 GBq/step after a 6-week interval without unacceptable adverse events in at least five consecutive patients. Absorbed doses to the various organs were calculated according to the MIRD formalism, based on three gamma-scintigraphic studies. Response was assessed by means of MRI and alpha-fetoprotein (AFP) monitoring.ResultsThirty-five treatments were carried out in 28 patients. Activities from 4.8 to 7.0 GBq 188Re-HDD/lipiodol were administered via a transfemoral catheter. The mean absorbed dose to the liver (including tumour) was 7.6±2.2, 9.8±4.9 and 15.2±4.9 Gy for the 4.8-, 5.9- and 7.0-GBq groups, respectively. Treatment was well tolerated at all activity levels. Further escalation of the administered activity was not feasible owing to limitations related to the radiolabelling procedure. Response assessment on MRI showed partial response, stable disease and disease progression in 1, 28 and 2 assessable treatments, respectively. In 8 of 17 treatment sessions with an initially elevated AFP, a reduction ranging from 19% to 97% was observed 6 weeks later.ConclusionFollowing the intra-arterial administration of 4.8–7.0 GBq 188Re-HDD/lipiodol in patients with HCC and well-compensated liver cirrhosis, no severe adverse events occurred. Further escalation was not feasible owing to limitations in the radiolabelling procedure.
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