Dosimetric parameters predicting contralateral liver hypertrophy after unilobar radioembolization of hepatocellular carcinoma View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-11-25

AUTHORS

Xavier Palard, Julien Edeline, Yan Rolland, Samuel Le Sourd, Marc Pracht, Sophie Laffont, Laurence Lenoir, Karim Boudjema, Thomas Ugen, Vanessa Brun, Habiba Mesbah, Laure-Anne Haumont, Pascal Loyer, Etienne Garin

ABSTRACT

PURPOSE: This study aimed at identifying prior therapy dosimetric parameters using 99mTc-labeled macro-aggregates of albumin (MAA) that are associated with contralateral hepatic hypertrophy occurring after unilobar radioembolization of hepatocellular carcinoma (HCC) performed with 90Y-loaded glass microspheres. METHODS: The dosimetry data of 73 HCC patients were collected prior to the treatment with 90Y-loaded microspheres for unilateral disease. The injected liver dose (ILD), the tumor dose (TD) and healthy injected liver dose (HILD) were calculated based on MAA quantification. Following treatment, the maximal hypertrophy (MHT) of an untreated lobe was calculated. RESULTS: Mean MHT was 35.4 ± 40.4%. When using continuous variables, the MHT was not correlated with any tested variable, i.e., injected activity, ILD, HILD or TD except with a percentage of future remnant liver (FRL) following the 90Y-microspheres injection (r = -0.56). MHT ≥ 10% was significantly more frequent for patients with HILD ≥ 88 Gy, (52% of the cases), i.e., in 92.2% versus 65.7% for HILD < 88 Gy (p = 0.032). MHT ≥ 10% was also significantly more frequent for patients with a TD ≥ 205 Gy and a tumor volume (VT) ≥ 100 cm3 in patients with initial FRL < 50%. MHT ≥10% was seen in 83.9% for patients with either an HILD ≥ 88 Gy or a TD ≥ 205 Gy for tumors larger than 100cm3 (85% of the cases), versus only 54.5% (p = 0.0265) for patients with none of those parameters. MHT ≥10% was also associated with FRL and the Child-Pugh score. Using multivariate analysis, the Child-Pugh score (p < 0.0001), FRL (p = 0.0023) and HILD (p = 0.0029) were still significantly associated with MHT ≥10%. CONCLUSION: This study demonstrates for the first time that HILD is significantly associated with liver hypertrophy. There is also an impact of high tumor doses in large lesions in one subgroup of patients. Larger prospective studies evaluating the MAA dosimetric parameters have to be conducted to confirm these promising results. More... »

PAGES

392-401

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00259-017-3845-7

    DOI

    http://dx.doi.org/10.1007/s00259-017-3845-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1092978197

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29177870


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    325 Department of Medical Information, Cancer Institute Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France
    326 Department of Medical Oncology, Cancer Institute Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France
    327 Department of Nuclear Medicine, Cancer Institute Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France
    328 schema:name Department of Medical Imaging, Cancer Institute Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France
    329 Department of Medical Information, Cancer Institute Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France
    330 Department of Medical Oncology, Cancer Institute Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France
    331 Department of Nuclear Medicine, Cancer Institute Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes cedex, France
    332 INSERM, INRA, Univ Rennes 1, Univ Bretagne Loire, Nutrition Metabolisms and Cancer (NuMeCan), Rennes, France
    333 University of Rennes 1, 35033 Rennes, France
    334 rdf:type schema:Organization
     




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