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Dose–effect relationships in neuroendocrine tumour liver metastases treated with [166Ho]-radioembolization
Purpose Aim of this study was to investigate a dose-response relationship, dose-toxicity relationship, progression free survival (PFS) and overall survival (OS) in neuroendocrine tumour liver metastases (NELM) treated with holmium-166-microspheres radioembolization ([ 166 Ho]-radioembolization). Mat...
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Published in: | European journal of nuclear medicine and molecular imaging 2024-06, Vol.51 (7), p.2114-2123 |
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Main Authors: | , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
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Summary: | Purpose
Aim of this study was to investigate a dose-response relationship, dose-toxicity relationship, progression free survival (PFS) and overall survival (OS) in neuroendocrine tumour liver metastases (NELM) treated with holmium-166-microspheres radioembolization ([
166
Ho]-radioembolization).
Materials and methods
Single center, retrospective study included patients with NELM that received [
166
Ho]-radioembolization with post-treatment SPECT/CT and CECT or MRI imaging for 3 months follow-up. Post-treatment SPECT/CT was used to calculate tumour (D
t
) and whole liver healthy tissue (D
h
) absorbed dose. Clinical and laboratory toxicity was graded by Common Terminology Criteria for Adverse Events (CTCAE), version 5 at baseline and three-months follow-up. Response was determined according to RECIST 1.1. The tumour and healthy doses was correlated to lesion-based objective response and patient-based toxicity. Kaplan Meier analyses were performed for progression free survival (PFS) and overall survival (OS).
Results
Twenty-seven treatments in 25 patients were included, with a total of 114 tumours. Median follow-up was 14 months (3 – 82 months). Mean D
t
in non-responders was 68 Gy versus 118 Gy in responders,
p
= 0.01. ROC analysis determined 86 Gy to have the highest sensitivity and specificity, resp. 83% and 81%. Achieving a D
t
of ≥ 120 Gy provided the highest likelihood of response (90%) for obtaining response. Sixteen patients had grade 1–2 clinical toxicity and only one patient grade 3. No clear healthy liver dose-toxicity relationship was found. The median PFS was 15 months (95% CI [10.2;19.8]) and median OS was not reached.
Conclusion
This study confirms the safety and efficacy of [
166
Ho]-radioembolization in NELM in a real-world setting. A clear dose–response relationship was demonstrated and future studies should aim at a D
t
of ≥ 120 Gy, being predictive of response. No dose-toxicity relationship could be established. |
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ISSN: | 1619-7070 1619-7089 |
DOI: | 10.1007/s00259-024-06645-6 |