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. 2021 Oct 5;11(1):19745.
doi: 10.1038/s41598-021-99219-7.

Assessment of radiation sensitivity of unresectable intrahepatic cholangiocarcinoma in a series of patients submitted to radioembolization with yttrium-90 resin microspheres

Tommaso Depalo  1 , Antonio Claudio Traino  2 , Irene Bargellini  3 , Giulia Lorenzoni  3 , Elena Bozzi  3 , Caterina Vivaldi  4 , Rocco Lamastra  2 , Gianluca Masi  4 , Roberto Cioni  3 , Giuseppe Boni  5 , Duccio Volterrani  5
Affiliations

Assessment of radiation sensitivity of unresectable intrahepatic cholangiocarcinoma in a series of patients submitted to radioembolization with yttrium-90 resin microspheres

Tommaso Depalo et al. Sci Rep. .

Abstract

Radioembolization is a valuable therapeutic option in patients with unresectable intrahepatic cholangiocarcinoma. The essential implementation of the absorbed dose calculation methods should take into account also the specific tumor radiosensitivity, expressed by the α parameter. Purpose of this study was to retrospectively calculate it in a series of patients with unresectable intrahepatic cholangiocarcinoma submitted to radioembolization. Twenty-one therapeutic procedures in 15 patients were analysed. Tumor absorbed doses were calculated processing the post-therapeutic 90Y-PET/CT images and the pre-treatment contrast-enhanced CT scans. Tumor absorbed dose and pre- and post-treatment tumor volumes were used to calculate α and α3D parameters (dividing targeted liver in n voxels of the same volume with specific voxel absorbed dose). A tumor volume reduction was observed after treatment. The median of tumor average absorbed dose was 93 Gy (95% CI 81-119) and its correlation with the residual tumor mass was statistically significant. The median of α and α3D parameters was 0.005 Gy-1 (95% CI 0.004-0.008) and 0.007 Gy-1 (95% CI 0.005-0.015), respectively. Multivariate analysis showed tumor volume and tumor absorbed dose as significant predictors of the time to tumor progression. The knowledge of radiobiological parameters gives the possibility to decide the administered activity in order to improve the outcome of the treatment.

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Conflict of interest statement

Irene Bargellini received honoraria for Speaker activities from Sirtex Medical Europe GmbH, Biocompatibles UK LTD, Terumo Europe NV, Boston Scientific and for Advisory Boards from Sirtex Medical Europe GmbH and Biocompatibles UK LTD. Giuseppe Boni received honoraria for Speaker activities from Sirtex Medical Europe GmbH, Bayer Spa and Terumo Europe. Gianluca Masi received honoraria for Speaker activities and Advisory Boards from Sirtex Medical Europe GmbH and Bayer Spa. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A representation of imaging processing by using the dosimetry software (Simplicit90Y, Mirada Medical, Oxford, UK). On upper left panel (a), VOIs semi-automatically defined on the contrast-enhanced CT over the targeted liver and tumor. On upper central panel (b), the same VOIs transferred over the previously co-registered 90Y-PET. On upper right panel (c), calculated isodose distribution within the targeted liver and tumor. On bottom panel (d), dose-volume histograms (DVH) of the targeted liver and tumor.
Figure 2
Figure 2
The logarithmic correlation of the residual tumor mass expressed in percentage (Mf/M0) with tumor absorbed dose (r2 = 0.24, p < 0.04) (a) and D70 (r2 = 0.24, p < 0.04) (b).
Figure 3
Figure 3
The linear relationship between α and α3D values (r2 = 0.69; p = 0.0001).
See this image and copyright information in PMC

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