Details

Autor(en) / Beteiligte

• Ramdhani, K.
• Beijer-Verduin, J.
• Ebbers, S. C.
• van Rooij, R.
• Smits, M. L. J.
• Bruijnen, R. C. G.
• de Jong, H. W. A. M.
• Lam, M. G. E. H.
• Braat, A. J. A. T.

Titel

Dose–effect relationships in neuroendocrine tumour liver metastases treated with [166Ho]-radioembolization

Ist Teil von

• European journal of nuclear medicine and molecular imaging, 2024-06, Vol.51 (7), p.2114-2123

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2024

Quelle

2022 ECC(Springer)

Beschreibungen/Notizen

• 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.