Optimising Dosimetric Techniques using Planar 99mTc- MAA Imaging for Selective Internal Radiotherapy

2021 ◽  
Vol 84 ◽  
pp. 288
Author(s):  
Niamh McArdle ◽  
Linda Tutty ◽  
Seán Cournane ◽  
Julie Lucey ◽  
Jackie McCavana
Keyword(s):  
Selective Internal Radiotherapy ◽  
Internal Radiotherapy

scholarly journals Clinical Impact of 99mTc-MAA SPECT/CT-based Personalized Predictive Dosimetry in Selective Internal Radiotherapy: a Retrospective, Single-center Study for Unresectable HCC Patients

2021 ◽  
Author(s):  
Ana-Maria Bucalau ◽  
Benoît Collette ◽  
Illario Tancredi ◽  
Michael Vouche ◽  
Martina Pezzullo ◽  
...  
Keyword(s):  
Response Rate ◽  
A Posteriori ◽  
Selective Internal Radiotherapy ◽  
Internal Radiotherapy ◽  
Single Center Study ◽  
Group A ◽  
Group B ◽  
Predictive Dosimetry ◽  
Administered Activity ◽  
Center Study

Abstract BackgroundRecent data indicates that personalized dosimetry-based selective internal radiotherapy (SIRT) may be associated with better outcome for unresectable hepatocellular carcinoma (HCC).AimWe aim to evaluate the contribution of personalized predictive dosimetry (performed with Simplicity90® software) in HCC patients by comparing them to our historical cohort whose activity was determined by standard dosimetry. MethodsThis is a retrospective, single-center study conducted between February 2016 and December 2020 that included patients with HCC who received SIRT after simulation based on either standard dosimetry (group A) or, as of December 2017, on personalized dosimetry (group B). Primary objectives were best overall response (BOR) and objective response rate (ORR) evaluated by mRECIST at 3 months. Safety and toxicity profiles were evaluated at day 1, 1- and 3-months post-treatment. For group A we studied the dose-response relationship at 3 months and compared the activity to be administered determined a posteriori using Simplicit90Y® and the activity actually administered determined by the standard approach.ResultsBetween February 2016 and December 2020, 66 patients received 69 simulations leading to 40 treatments. The median follow-up time was equal for both groups, 21 months (range 3-55) in group A and 21 months (range 4-39) in group B. The per patient analysis revealed a significant benefit of personalized predictive dosimetry in terms of better overall response at 3 months (80% vs. 33.3%, p= 0.007) and at 6 months (77.8% vs. 22.2%, p= 0.06). This trend was found in the analysis by nodule with a response rate according to mRECIST of 87.5% for personalized dosimetry versus 68.4% for standard dosimetry at 3 months, p= 0.24. Only one grade 3 biological toxicity (hyperbilirubinemia) was noted in group A. The comparison between the administered activity and the recommended activity recalculated a posteriori using Simplicit90Y® showed that the vast majority of patients who progressed (83.33%) received less activity than that recommended by the personalized approach or an inadequate distribution of the administered activity. ConclusionsOur study confirms that the use of personalized dosimetry allows a better selection of HCC patients who can benefit from SIRT, and consequently, improves the effectiveness of this treatment.

scholarly journals Quality of life in the FOXFIRE, SIRFLOX and FOXFIRE‐global randomised trials of selective internal radiotherapy for metastatic colorectal cancer

2020 ◽  
Vol 147 (4) ◽  
pp. 1078-1085
Author(s):  
Jane Wolstenholme ◽  
Francesco Fusco ◽  
Alastair M. Gray ◽  
Joanna Moschandreas ◽  
Pradeep S. Virdee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Randomised Trials ◽  
Selective Internal Radiotherapy ◽  
Internal Radiotherapy

scholarly journals Embolotherapy for Hepatic Oncology: Current Perspectives and Future Directions

2020 ◽  
Vol 04 (02) ◽  
pp. 134-147
Author(s):  
Raazi Bajwa ◽  
David C. Madoff ◽  
Sirish A. Kishore
Keyword(s):  
Artificial Intelligence ◽  
Liver Tumors ◽  
Transarterial Embolization ◽  
Supportive Evidence ◽  
Selective Internal Radiotherapy ◽  
Future Directions ◽  
Locoregional Treatment ◽  
Internal Radiotherapy ◽  
Liver Cancers ◽  
Bland Embolization

AbstractPrimary and secondary liver cancers are a major cause of mortality worldwide. Transarterial liver-directed therapy, or embolotherapy, represents an important locoregional treatment strategy for primary and secondary liver tumors. Embolotherapeutic modalities include bland embolization (transarterial embolization), chemoembolization (transarterial chemoembolization), and radioembolization or selective internal radiotherapy. A brief technical overview of embolotherapeutic modalities as well as supportive evidence for the treatment of most common primary and secondary liver tumors will be discussed in this review. Several potential future applications, including synergy with systemic therapy, interventional theranostics, and artificial intelligence will also be reviewed briefly.

Standardization of 90Y-labelled SIR-Spheres used for selective internal radiotherapy

2015 ◽  
Vol 31 ◽  
pp. e27
Author(s):  
V. Lourenço ◽  
C. Bobin ◽  
V. Chisté ◽  
C. Thiam ◽  
D. Lacour ◽  
...  
Keyword(s):  
Selective Internal Radiotherapy ◽  
Internal Radiotherapy

Overall survival analysis of the FOXFIRE prospective randomized studies of first-line selective internal radiotherapy (SIRT) in patients with liver metastases from colorectal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3507-3507 ◽  
Author(s):  
Ricky A. Sharma ◽  
Harpreet Singh Wasan ◽  
Guy A. Van Hazel ◽  
Volker Heinemann ◽  
Navesh K. Sharma ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Response Rate ◽  
Objective Response ◽  
Hepatic Metastases ◽  
First Line ◽  
Selective Internal Radiotherapy ◽  
Internal Radiotherapy ◽  
Randomized Studies

3507 Background: The FOXFIRE, SIRFLOX and FOXFIRE-Global (FF-SF-FFG) randomized studies evaluated the efficacy of combining first-line chemotherapy for metastatic colorectal cancer (mCRC) with selective internal radiotherapy (SIRT) using yttrium-90 resin microspheres in patients with liver metastases. The studies were designed for prospective, combined analysis of overall survival (OS). Methods: FF-SF-FFG randomized (1:1) chemotherapy-naïve mCRC patients (performance status 0/1) with liver metastases not suitable for curative resection/ablation. Arm A was oxaliplatin-based chemotherapy (mFOLFOX6/ OxMdG) ± investigator-chosen biologically targeted agent. Arm B was the same systemic therapy (oxaliplatin dose modification) + single treatment SIRT with cycle 1/2 of chemotherapy. Primary tumor in situ and/or limited extra-hepatic metastases were permitted. Minimum sample size was 1075 patients (HR 0.8, 80% power, two-sided 5% significance). Secondary outcomes included PFS, liver-specific PFS and response rate. Apart from safety, outcomes were analysed on intention-to-treat population using meta-analytic methods of pooled individual patient data. Results: Between 2006 and 2014, 1103 patients were randomized in 14 countries. Median age was 63 years (range 23-89); median follow-up 43.3 months. There were 844 deaths. There was no difference in OS (HR 1.04; 95% CI 0.90-1.19, p= 0.609) or PFS (HR 0.90, CI 0.79-1.02, p= 0.108) between Arms. Objective response rate ( p= 0.001) and liver-specific progression (HR 0.51, CI 0.43-0.62, p< 0.001) were significantly more favorable in Arm B. Patients in Arm B had higher risk of non-liver progression as first event (HR 1.98, CI 1.53-2.58, p< 0.001). Grade 3-5 adverse events were more common in Arm B (74.0%) than A (66.5%), p= 0.009. In health status questionnaires, EQ-5D utility scores were not significantly different between Arms at 6, 12 or 24 months. Conclusion: Despite higher response rates and improved liver-specific PFS, the addition of SIRT to first-line oxaliplatin-fluorouracil chemotherapy for patients with liver-only and liver-dominant mCRC did not improve OS or PFS. Clinical trial information: 83867919.

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