Back to Search
Start Over
Intra-arterial rhenium-188 lipiodol in the treatment of inoperable hepatocellular carcinoma: results of an IAEA-sponsored multination study.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2007 Dec 01; Vol. 69 (5), pp. 1448-55. Date of Electronic Publication: 2007 Aug 09. - Publication Year :
- 2007
-
Abstract
- Purpose: Intra-arterial injections (IAI) of 131I-lipiodol is effective in treating hepatocellular carcinoma patients, but is expensive and requires a 7-day hospitalization in a radioprotection room. 188Re is inexpensive, requires no patient isolation, and can be used with lipiodol.<br />Methods and Materials: This International Atomic Energy Agency-sponsored phase II trial aimed to assess the safety and the efficacy of a radioconjugate 188Re + lipiodol (188Re-Lip) in a large cohort of hepatocellular carcinoma patients from developing countries. A scout dose is used to determine the maximal tolerated dose (lungs <12 Gy, normal liver <30 Gy, bone marrow <1.5 Gy) and then the delivery of the calculated activity. Efficacy was assessed using response evaluation criteria in solid tumor (RECIST) and alpha-feto-protein (alpha FP) levels and severe adverse events were graded using the Common Toxicity Criteria of the National Cancer Institute scale v2.0.<br />Results: The trial included 185 patients from eight countries. The procedure was feasible in all participating centers. One treatment was given to 134 patients; 42, 8, and 1 received two, three, and four injections, respectively. The injected activity during the first treatment was 100 mCi. Tolerance was excellent. We observed three complete responses and 19 partial responses (22% of evaluable patients, 95% confidence interval 16-35%); 1- and 2-year survivals were 46% and 23%. Some factors affected survival: country of origin, existence of a cirrhosis, Cancer of the Liver Italian Program score, tumor dose, absence of progression, and posttreatment decrease in alpha FP level.<br />Conclusions: IAI of 188Re-Lip in developing countries is feasible, safe, cost-effective, and deserves a phase III trial.
- Subjects :
- Adult
Aged
Aged, 80 and over
Bilirubin blood
Biomarkers blood
Carcinoma, Hepatocellular mortality
Carcinoma, Hepatocellular pathology
Female
Humans
Injections, Intra-Arterial
Iodized Oil adverse effects
Liver Cirrhosis complications
Liver Cirrhosis mortality
Liver Neoplasms mortality
Liver Neoplasms pathology
Male
Maximum Tolerated Dose
Middle Aged
Radioisotopes adverse effects
Regression Analysis
Remission Induction
Rhenium adverse effects
Statistics, Nonparametric
Carcinoma, Hepatocellular radiotherapy
Iodized Oil administration & dosage
Liver Neoplasms radiotherapy
Radioisotopes administration & dosage
Rhenium administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 0360-3016
- Volume :
- 69
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 17692473
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2007.05.009