Combined Yttrium-90 microsphere selective internal radiation therapy and external beam radiotherapy in patients with hepatocellular carcinoma: From clinical aspects to dosimetry

PloS One
Ti-Hao WangRheun-Chuan Lee

Abstract

Selective internal radiation therapy (SIRT) is an effective treatment strategy for unresectable hepatocellular carcinoma (HCC) patients. However, the prognoses of patients with portal vein thrombosis, extra-hepatic metastases, or residual tumors remain poor when treated with SIRT alone. In these patients, sequential external beam radiotherapy (EBRT) may offer a chance of salvage. Here, we reported the clinical outcomes and the detailed dosimetry analysis of 22 patients treated with combination therapy. Between October 2011 and May 2015, 22 consecutive patients who underwent EBRT after yttrium-90 (90Y) SIRT were included in this study. The post-SIRT 90Y bremsstrahlung SPECT/CT of each patient was transferred to dose distribution by adopting the local deposition hypothesis. The patient-specific 3-dimensional biological effective dose distribution of combined SIRT and EBRT was generated. The overall survival and safety were evaluated. The relationship between dosimetric parameters and liver toxicity was analyzed. The mean administered activity of SIRT was 1.50 GBq (range: 0.5-2.8). The mean prescribed dose of EBRT was 42.3 Gy (range: 15-63) in 14 fractions (range: 5-15) and was targeted to the residual liver tumor in 12 patients (...Continue Reading

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Citations

May 7, 2019·Nuclear Medicine and Molecular Imaging·Ko-Han LinWen-Sheng Huang
Jan 2, 2020·APL Bioengineering·Gregory H Underhill, Salman R Khetani
Dec 22, 2020·Nuclear Medicine Communications·Yung Hsiang Kao
Nov 30, 2021·Nuklearmedizin. Nuclear Medicine·Robert FreudenbergJörg Kotzerke

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Software Mentioned

R
R “ DVHmetrics ”
SIRT
Eclipse
Matlab
mRECIST

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