Radioembolization with
Autor: | A J A T, Braat, H, Ahmadzadehfar, S C, Kappadath, C L, Stothers, A, Frilling, C M, Deroose, P, Flamen, D B, Brown, D Y, Sze, A, Mahvash, M G E H, Lam |
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Rok vydání: | 2019 |
Předmět: |
Adult
Aged 80 and over Male Yttrium-90 Receptors Peptide Brachytherapy Liver Neoplasms NEN Middle Aged Microspheres Neuroendocrine Tumors Treatment Outcome Neuroendocrine tumours Humans Female Yttrium Radioisotopes SIRT Clinical Investigation PRRT Radioembolization Response Evaluation Criteria in Solid Tumors Aged Retrospective Studies |
Zdroj: | Cardiovascular and Interventional Radiology |
ISSN: | 1432-086X |
Popis: | Purpose Peptide receptor radionuclide therapy (PRRT) and radioembolization are increasingly used in neuroendocrine neoplasms patients. However, concerns have been raised on cumulative hepatotoxicity. The aim of this sub-analysis was to investigate hepatotoxicity of yttrium-90 resin microspheres radioembolization in patients who were previously treated with PRRT. Methods Patients treated with radioembolization after systemic radionuclide treatment were retrospectively analysed. Imaging response according to response evaluation criteria in solid tumours (RECIST) v1.1 and clinical response after 3 months were collected. Clinical, biochemical and haematological toxicities according to common terminology criteria for adverse events (CTCAE) v4.03 were also collected. Specifics on prior PRRT, subsequent radioembolization treatments, treatments after radioembolization and overall survival (OS) were collected. Results Forty-four patients were included, who underwent a total of 58 radioembolization procedures, of which 55% whole liver treatments, at a median of 353 days after prior PRRT. According to RECIST 1.1, an objective response rate of 16% and disease control rate of 91% were found after 3 months. Clinical response was seen in 65% (15/23) of symptomatic patients after 3 months. Within 3 months, clinical toxicities occurred in 26%. Biochemical and haematological toxicities CTCAE grade 3–4 occurred in ≤ 10%, apart from lymphocytopenia (42%). Radioembolization-related complications occurred in 5% and fatal radioembolization-induced liver disease in 2% (one patient). A median OS of 3.5 years [95% confidence interval 1.8–5.1 years] after radioembolization for the entire study population was found. Conclusion Radioembolization after systemic radionuclide treatments is safe, and the occurrence of radioembolization-induced liver disease is rare. Level of Evidence 4, case series. |
Databáze: | OpenAIRE |
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