<script type="math/tex">^{188}Re</script>-HDD/lipiodol therapy for hepatocellular carcinoma : an activity escalation study

Lambert, B.; Bacher, K.; Defreyne, L.; van Meerbeeck, J.P.; et al.

doi:10.1007/S00259-005-1954-1

Title

$^{188}Re$ -HDD/lipiodol therapy for hepatocellular carcinoma : an activity escalation study

Author

Lambert, B.

Bacher, K.

Defreyne, L.

van Meerbeeck, J.P.

et al.

Abstract

Purpose: The aim of this study was to investigate the feasibility of administering increasing activities of Re-188-4-hexadecyl-1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol/lipiodol (Re-188-HDD/lipiodol) for the treatment of hepatocellular carcinoma (HCC) in patients with well-compensated cirrhosis. Methods: The 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. Results: Thirty-five treatments were carried out in 28 patients. Activities from 4.8 to 7.0 GBq Re-188-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. Conclusion: Following the intra-arterial administration of 4.8 - 7.0 GBq Re-188-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.

Language

English

Source (journal)

European journal of nuclear medicine and molecular imaging. - Heidelberg, 2002, currens

Publication

Heidelberg : Springer , 2006

ISSN

1619-7070 [print]

1619-7089 [online]

DOI

10.1007/S00259-005-1954-1

Volume/pages