Phase II Study of Transarterial Holmium-166-Chitosan Complex Treatment in Patients with a Single, Large Hepatocellular Carcinoma
| Autor: | Jong Tae Lee, Kyungsoo Park, Nae Choon Yoo, Kyung Bae Park, Jong Doo Lee, Joo Hang Kim, Joohyuk Sohn, Young Myung Moon, Eunhee Kim, Hye Jin Choi |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Carcinoma Hepatocellular medicine.medical_treatment Phases of clinical research Antineoplastic Agents Gastroenterology Holmium Young Adult Liver Function Tests Internal medicine medicine Carcinoma Humans Survival rate Radioisotopes Chitosan Dose-Response Relationship Drug medicine.diagnostic_test business.industry Drug Administration Routes Patient Selection Cancer Radiotherapy Dosage General Medicine Models Theoretical medicine.disease digestive system diseases Survival Rate Radiation therapy Oncology Hepatocellular carcinoma Liver cancer Liver function tests Nuclear medicine business |
| Zdroj: | Oncology. 76:1-9 |
| ISSN: | 1423-0232 0030-2414 |
| Popis: | Purpose: Holmium-166 (166Ho) is a neutron-activated radioactive isotope whose effectiveness in hepatocellular carcinoma (HCC) was first reported in a preclinical study in 1991. Chitosan is a polymer of 2-deoxy-2-amino-D-glucose that readily forms a chelate with heavy metals and converts from a solution under acidic conditions into a gel under neutral or basic conditions. We performed a prospective trial of a transarterial administration of a radiopharmaceutical 166Ho-chitosan complex in patients with single, large HCC. Patients and Methods: The study involved 54 patients who had single HCC (≥3 cm) without a vascular shunt and were either inoperable or refused surgery. The 166Ho-chitosan complex was administered at a dose of 20 mCi per cm of tumor diameter (capping at 200 mCi) via the artery that directly fed the tumor. Results: The median tumor size was 5.3 cm (range: 3–13 cm). The response rate was 78% (42/54), and 31 patients had a complete response for a median duration of 27 months. The incidence of grade 3 or 4 leukopenia was 18.6%, anemia 7.4%, thrombocytopenia 27.8%, AST/ALT elevation 26%/24%, and total bilirubin elevation 5.6%. There were two treatment-related deaths (3.7%). Subset analysis revealed a substantial difference between the two groups categorized by tumor size (3–5 vs. >5 cm) with respect to response rate (p = 0.004) and overall survival (p = 0.02). Conclusion: We found that transarterial administration of the 166Ho-chitosan complex was highly effective in the treatment of HCC with acceptable toxicities, especially for patients with tumors of 3–5 cm. |
| Databáze: | OpenAIRE |
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