Insights into the dose-response relationship of radioembolization with resin yttrium-90 microspheres: a prospective cohort study in patients with colorectal cancer liver metastases

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
Andor F van den HovenMarnix G E H Lam

Abstract

Randomized controlled trials are investigating the benefit of hepatic radioembolization added to systemic therapy in the first/second-line treatment of patients with colorectal liver metastases (CRLM). Remarkably, administered activity may still be suboptimal, because a dose-response relationship has not been defined. The purpose of this study was to characterize the relationship between tumor absorbed dose and response after (90)Y-radioembolization treatment for CRLM. 30 patients with unresectable chemorefractory CRLM were treated with resin (90)Y-microspheres in a prospective phase II clinical trial. Tumor absorbed dose was quantified on (90)Y-PET. Metabolic tumor activity, defined as tumor lesion glycolysis (TLG*) on (18)F-FDG-PET, was measured at baseline and 1 month posttreatment. The relationship between tumor absorbed dose and posttreatment metabolic activity was assessed per metastasis, with a linear mixed effects regression model. 133 treated metastases were identified. Mean tumor absorbed dose was 51 ± 28 Gy (range 7 - 174 Gy). A 50% reduction in TLG* was achieved in 46% of metastases, and in 11/30 (37%) patients for the sum of metastases. The latter was associated with prolonged median overall survival (11.6 vs. 6.6 ...Continue Reading

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Citations

Mar 17, 2017·Journal of Applied Clinical Medical Physics·Maryam FallahpoorFaraz Kalantari
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