Adjuvant holmium-166 radioembolization after radiofrequency ablation in early-stage hepatocellular carcinoma patients: a dose-finding study (HORA EST HCC trial).

Autor: Hendriks P; Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. p.hendriks@lumc.nl., Rietbergen DDD; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., van Erkel AR; Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands., Coenraad MJ; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands., Arntz MJ; Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands., Bennink RJ; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Braat AE; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Crobach S; Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands., van Delden OM; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Dibbets-Schneider P; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., van der Hulle T; Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands., Klümpen HJ; Department of Medical Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., van der Meer RW; Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands., Nijsen JFW; Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands., van Rijswijk CSP; Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands., Roosen J; Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands., Ruijter BN; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands., Smit F; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Stam MK; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Takkenberg RB; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Tushuizen ME; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands., van Velden FHP; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., de Geus-Oei LF; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.; Biomedical Photonic Imaging Group, TechMed Center, University of Twente, Enschede, The Netherlands.; Department of Radiation Sciences & Technology, Delft University of Technology, Delft, The Netherlands., Burgmans MC; Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2024 Jun; Vol. 51 (7), pp. 2085-2097. Date of Electronic Publication: 2024 Feb 08.
DOI: 10.1007/s00259-024-06630-z
Abstrakt: Purpose: The aim of this study was to investigate the biodistribution of (super-)selective trans-arterial radioembolization (TARE) with holmium-166 microspheres ( 166 Ho-MS), when administered as adjuvant therapy after RFA of HCC 2-5 cm. The objective was to establish a treatment volume absorbed dose that results in an absorbed dose of ≥ 120 Gy on the hyperemic zone around the ablation necrosis (i.e., target volume).
Methods: In this multicenter, prospective dose-escalation study in BCLC early stage HCC patients with lesions 2-5 cm, RFA was followed by (super-)selective infusion of 166 Ho-MS on day 5-10 after RFA. Dose distribution within the treatment volume was based on SPECT-CT. Cohorts of up to 10 patients were treated with an incremental dose (60 Gy, 90 Gy, 120 Gy) of 166 Ho-MS to the treatment volume. The primary endpoint was to obtain a target volume dose of ≥ 120 Gy in 9/10 patients within a cohort.
Results: Twelve patients were treated (male 10; median age, 66.5 years (IQR, [64.3-71.7])) with a median tumor diameter of 2.7 cm (IQR, [2.1-4.0]). At a treatment volume absorbed dose of 90 Gy, the primary endpoint was met with a median absorbed target volume dose of 138 Gy (IQR, [127-145]). No local recurrences were found within 1-year follow-up.
Conclusion: Adjuvant (super-)selective infusion of 166 Ho-MS after RFA for the treatment of HCC can be administered safely at a dose of 90 Gy to the treatment volume while reaching a dose of ≥ 120 Gy to the target volume and may be a favorable adjuvant therapy for HCC lesions 2-5 cm.
Trial Registration: Clinicaltrials.gov NCT03437382 . (registered: 19-02-2018).
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: