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. 2005 Dec 31;46(6):799-805.
doi: 10.3349/ymj.2005.46.6.799.

A pilot study of trans-arterial injection of 166Holmium-Chitosan complex for treatment of small hepatocellular carcinoma

Byoung Chul Cho  1 , Eun Hee Kim, Hye Jin Choi, Joo Hang Kim, Jae Kyung Roh, Hyun Cheol Chung, Joong Bae Ahn, Jong Doo Lee, Jong Tae Lee, Nae Choon Yoo, Joo Hyuk Sohn
Affiliations

A pilot study of trans-arterial injection of 166Holmium-Chitosan complex for treatment of small hepatocellular carcinoma

Byoung Chul Cho et al. Yonsei Med J. .

Abstract

Percutaneous approaches, such as percutaneous ethanol injection and radiofrequency ablation, have been most widely used for hepatocellular carcinoma patients who were not eligible for surgery. New technologies to improve the efficacy are currently needed. (166)Holmium is a neutron activated radionuclide, and has several beneficial radiophysical characteristics for internal radiation therapy. (166)Holmium-Chitosan complex, in which chitosan is chelated with (166)Holmium, was developed as a radiopharmaceutical for cancer therapy. We have conducted a pilot study to evaluate the clinical efficacy of transarterial administration of (166)Holmium-Chitosan complex in patients with a single and small (< 3 cm) hepatocellular carcinoma. (166)Holmium-Chitosan complex, at a dose of 20 mCi per cm of tumor mass-diameter, was administered through the artery that directly fed the tumor. Twelve patients were treated with a median follow-up duration of 26 (range: 12-61) months. The tumor diameter ranged between 1.5 and 2.5 cm. Ten patients (83%) had complete response and two (17%) had partial response. The median complete response duration was not reached. The median AFP level declined from 83.8 to 8.3 ng/mL within 2 months after treatment. No grade III/IV toxicity was observed. Grade I and II toxicities were observed in four patients (2 abdominal pain, 1 fever, and 1 AST/ALT elevation). No toxic death occurred. This preliminary study shows a promising and durable complete response rate with an acceptable safety profile. Further studies with greater accrual of patients are warranted.

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Figures

Fig. 1
Fig. 1
CT scan (A) and angiography (B) of a 2 cm hypervascular HCC (arrow) before trans-arterial 166Holmium-Chitosan complex.
Fig. 2
Fig. 2
CT scan (A) and angiography (B) showing complete tumor response 4 weeks after treatment.
Fig. 3
Fig. 3
AFP level changes in all patients (n = 12), within the 2 months after 166Ho treatment.
Fig. 4
Fig. 4
Gamma scan obtained immediately after treatment shows 166Holmium-Chitosan complex retained within tumor mass.
See this image and copyright information in PMC

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