A novel approach to brachytherapy in hepatocellular carcinoma using a phosphorous32 (32P) brachytherapy delivery device--a first-in-man study
Autor: | Beng-Choo Lim, Anthony S. W. Goh, Richard Lo, Somanesan Satchithanantham, Alexander Y. F. Chung, Susan Loong, Te-Neng Lau, Stephen Connor, David Chee Eng Ng, Sidney Yu, May Chng, Pierce K. H. Chow |
---|---|
Rok vydání: | 2006 |
Předmět: |
Male
Cancer Research medicine.medical_specialty Percutaneous Carcinoma Hepatocellular medicine.medical_treatment Brachytherapy Radiography Interventional medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Local anesthesia Adverse effect Ultrasonography Interventional Aged Aged 80 and over First-in-man study Radiation business.industry Liver Neoplasms Silicon Compounds Radiotherapy Dosage Middle Aged medicine.disease Treatment Outcome Oncology Hepatocellular carcinoma Female Radiology Nuclear medicine business Tomography X-Ray Computed Phosphorus Radioisotopes Progressive disease |
Zdroj: | International journal of radiation oncology, biology, physics. 67(3) |
ISSN: | 0360-3016 |
Popis: | Purpose: While potentially very useful, percutaneously delivered brachytherapy of inoperable intra-abdominal solid tumors faces significant technical challenges. This first-in-man study is designed to determine the safety profile and therapeutic efficacy of a novel phosphorous ( 32 P) brachytherapy device (BrachySil) in patients with unresectable hepatocellular carcinoma. Methods and Materials: Patients received single percutaneous and transperitoneal implantations of BrachySil under local anesthesia directly into liver tumors under ultrasound or computed tomographic guidance, at an activity level of 4 MBq/cc of tumor. Toxicity was assessed by the nature, incidence, and severity of adverse events (Common Toxicity Criteria scores) and by hematology and clinical chemistry parameters. Target tumor response was assessed with computed tomographic scans at 12 and 24 weeks postimplantation using World Health Organization criteria. Results: Implantations were successfully carried out in 8 patients (13–74 MBq, mean 40 MBq per tumor) awake and under local anesthesia. Six of the 8 patients reported 19 adverse events, but no serious events were attributable to the study device. Changes in hematology and clinical chemistry were similarly minimal and reflected progressive underlying hepatic disease. All targeted tumors were responding at 12 weeks, with complete response (100% regression) in three lesions. At the end of the study, there were two complete responses, two partial responses, three stable diseases, and one progressive disease. Conclusion: Percutaneous implantation of this novel 32 P brachytherapy device into hepatocellular carcinoma is safe and well tolerated. A significant degree of antitumor efficacy was demonstrated at this low dose that warrants further investigation. |
Databáze: | OpenAIRE |
Externí odkaz: |