Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep;45(10):1731-1741.
doi: 10.1007/s00259-018-3990-7. Epub 2018 Mar 20.

A MAA-based dosimetric study in patients with intrahepatic cholangiocarcinoma treated with a combination of chemotherapy and 90Y-loaded glass microsphere selective internal radiation therapy

Vincent Manceau  1 , Xavier Palard  1   2 , Yan Rolland  3   4   5 , March Pracht  6 , Samuel Le Sourd  6 , Sophie Laffont  1 , Karim Boudjema  7 , Astride Lievre  8 , Habiba Mesbah  9 , Laure-Anne Haumont  9 , Laurence Lenoir  1 , Vanessa Brun  10 , Thomas Uguen  7 , Julien Edeline  2   6   11 , Etienne Garin  12   13   14
Affiliations

A MAA-based dosimetric study in patients with intrahepatic cholangiocarcinoma treated with a combination of chemotherapy and 90Y-loaded glass microsphere selective internal radiation therapy

Vincent Manceau et al. Eur J Nucl Med Mol Imaging. 2018 Sep.

Abstract

Purpose: Selective internal radiation therapy (SIRT) appears to be an interesting treatment possibility for locally-advanced intrahepatic cholangiocarcinoma (ICC), yet the appropriate dosimetry has never been evaluated in this context.

Methods: We retrospectively studied data from 40 patients treated at our institution with 90Y-loaded glass microsphere SIRT combined with chemotherapy for inoperable ICC as first-line treatment. Macroaggregated albumin (MAA)-based single-photon emission computed tomography (SPECT)/computed tomography (CT) quantitative analysis was used to calculate the tumor dose (TD), healthy-injected liver dose (HILD), and injected liver dose (ILD). Response was evaluated at 3 months using the European Association for the Study of the Liver criteria. Factors associated with response and toxicity were analyzed using univariate analysis.

Results: We assessed a total of 35 patients (five excluded) receiving 55 injections. Mean TD was 322 ± 165Gy and mean HILD was 74 ± 24Gy for a mean ILD of 128 ± 28Gy. All but two lesions responded, with a minimal TD for responding lesions of 158Gy. Six Grade 3-4 permanent liver toxicities were observed. Mean HILD was not associated with liver toxicity (73.2 ± 25.8Gy for patients with liver toxicity and 77.8 ± 16.9Gy for patients without, ns). Only underlying Child-Pugh status (p = 0.0014) and underlying cirrhosis (p = 0.0021) were associated with liver toxicity. Median progression-free survival was 12.7 months and median overall survival (OS) was 28.6 months. Median OS was 52.7 months for patients with Child-Pugh A5 status.

Conclusions: When combined with chemotherapy, SIRT is highly effective, with a TD > 158Gy. Tolerance was good except for the few patients with cirrhosis or Child-Pugh status ≥A6, who exhibited some liver toxicity. Prospective studies are warranted to confirm.

Keywords: 90Y; Dosimetry; Intahepatic cholangiocarcinoma; Microspheres; Radioembolization.

PubMed Disclaimer

References

    1. Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):745-50 - PubMed
    1. Radiother Oncol. 2011 May;99(2):108-13 - PubMed
    1. N Engl J Med. 2010 Apr 8;362(14):1273-81 - PubMed
    1. Cancer. 2009 Feb 1;115(3):616-23 - PubMed
    1. J Nucl Med. 2015 Mar;56(3):339-46 - PubMed

Substances

LinkOut - more resources