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
. 2022 Apr;49(5):1700-1710.
doi: 10.1007/s00259-021-05642-3. Epub 2021 Dec 7.

Dose-response relationship after yttrium-90-radioembolization with glass microspheres in patients with neuroendocrine tumor liver metastases

Sander C Ebbers  1 , Caren van Roekel  1 , Manon N G J A Braat  1 , Maarten W Barentsz  1 , Marnix G E H Lam  1 , Arthur J A T Braat  2
Affiliations

Dose-response relationship after yttrium-90-radioembolization with glass microspheres in patients with neuroendocrine tumor liver metastases

Sander C Ebbers et al. Eur J Nucl Med Mol Imaging. 2022 Apr.

Abstract

Background: In radioembolization, response is achieved through the irradiation and damaging of tumor DNA. For hepatic metastases of neuroendocrine tumors, a dose-response relationship has not been established yet. This study assesses whether increasing tumor-absorbed doses lead to increased response rates.

Methods: We included all patients who underwent yttrium-90 (90Y) glass microspheres radioembolization in our center if both pre- and post-treatment contrast-enhanced CT and post-injection PET/CT were available. Up to five hepatic tumors and the healthy hepatic tissue were delineated, and absorbed dose was quantified using post-injection PET/CT. Response was measured according to RECIST 1.1 on patient and tumor level. Linear mixed models were used to study the relationship between absorbed dose and response on tumor level. Logistic regression analysis was used on patient level to study dose-response and hepatic dose-toxicity relationships.

Results: A total of 128 tumors in 26 patients (31 procedures) were included in the response analysis. While correcting for confounding by tumor volume, a significant effect of response on dose was found (p = 0.0465). Geometric mean of absorbed dose for responding tumors was 170 Gy, for stable disease 101 Gy, and for progressive disease 67 Gy. No significant dose-toxicity relationship could be identified.

Conclusion: In patients with neuroendocrine tumor liver metastases, treated with 90Y-radioembolization, a clear dose-response relationship was found. We propose to perform 90Y-radioembolization with an absolute minimum planned tumor-absorbed dose of 150 Gy.

Keywords: Dose–response; Liver metastases; Neuroendocrine neoplasm; Radioembolization; SIRT; Yttrium-90.

PubMed Disclaimer

References

    1. Hermann AL, Dieudonné A, Ronot M, Sanchez M, Pereira H, Chatellier G, et al. Relationship of tumor radiation–absorbed dose to survival and response in hepatocellular carcinoma treated with transarterial radioembolization with 90Y in the SARAH study. Radiology. 2020;296:673–84. https://doi.org/10.1148/radiol.2020191606 . - DOI - PubMed
    1. Alsultan AA, van Roekel C, Barentsz MW, Smits MLJ, Kunnen B, Koopman M, et al. Dose-response and dose-toxicity relationships for yttrium-90 glass radioembolization in patients with colorectal cancer liver metastases. J Nucl Med. 2021;jnumed.120.255745. https://doi.org/10.2967/jnumed.120.255745 .
    1. Chansanti O, Jahangiri Y, Matsui Y, Adachi A, Geeratikun Y, Kaufman JA, et al. Tumor dose response in yttrium-90 resin microsphere embolization for neuroendocrine liver metastases: a tumor-specific analysis with dose estimation using SPECT-CT. J Vasc Interv Radiol. 2017;28:1528–35. https://doi.org/10.1016/j.jvir.2017.07.008 . - DOI - PubMed
    1. Cheng B, Villalobos A, Sethi I, Wagstaff W, Galt J, Brandon D, et al. Determination of tumor dose response thresholds in patients with chemorefractory intrahepatic cholangiocarcinoma treated with resin and glass-based Y90 radioembolization. Cardiovasc Intervent Radiol. 2021;44:1194–203. https://doi.org/10.1007/s00270-021-02834-0 . - DOI - PubMed
    1. Barat M, Cottereau A-S, Kedra A, Dermine S, Palmieri L-J, Coriat R, et al. The role of interventional radiology for the treatment of hepatic metastases from neuroendocrine tumor: an updated review. J Clin Med. 2020;9:2302. https://doi.org/10.3390/jcm9072302 . - DOI - PMC

MeSH terms

LinkOut - more resources