Cancers, Vol. 12, Pages 1557: Personalised Dosimetry in Radioembolisation for HCC: Impact on Clinical Outcome and on Trial Design

Cancers, Vol. 12, Pages 1557: Personalised Dosimetry in Radioembolisation for HCC: Impact on Clinical Outcome and on Trial Design Cancers doi: 10.3390/cancers12061557 Authors: Etienne Garin Xavier Palard Yan Rolland Selective internal radiation therapy (SIRT) of hepatocellular carcinoma (HCC) has been used for many years, usually without any specific dosimetry endpoint. Despite good clinical results in early phase studies or in cohort studies, three randomized trials in locally advanced HCC available failed to demonstrate any improvement of overall overall survival (OS) in comparison with sorafenib. In recent years, many studies have evaluated the dosimetry of SIRT using either a simulation-based dosimetry (macroaggregated albumin (MAA)-based) or a post-therapy-based one (90Y-based). The goal of this review is to present the dosimetry concept, tools available, its limitations, and main clinical results described for HCC patients treated with 90Y-loaded resin or glass microspheres. With MAA-based dosimetry, the threshold tumor doses allowing for a response were between 100 and 210 Gy for resin microspheres and between 205 and 257 Gy for glass microspheres. The significant impact of the tumor dose on OS was reported with both devices. The correlation between 90Y-based dosimetry and response was also reported. Regarding the safety, preliminary results are available for both products but with a larger range of normal liver doses values correlated with liver toxicities...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research