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- Title
Radioembolisation with <sup>90</sup>Y-microspheres: dosimetric and radiobiological investigation for multi-cycle treatment.
- Authors
Cremonesi, Marta; Ferrari, Mahila; Bartolomei, Mirco; Orsi, Franco; Bonomo, Guido; Aricò, Demetrio; Mallia, Andrew; Cicco, Concetta; Pedroli, Guido; Paganelli, Giovanni
- Abstract
Radioembolisation with 90Y-microspheres is a new locoregional treatment of hepatic lesions, usually applied as single cycle. Multi-cycle treatments might be considered as a strategy to improve the risk-benefit balance. With the aim to derive suitable information for patient tailored therapy, available patients’ dosimetric data were reviewed according to the linear–quadratic model and converted into biological effective dose (BED) values. Single vs. multi-cycle approaches were compared through radiobiological perspective. Twenty patients with metastatic lesions underwent radioembolisation. The 90Y-administered activity (AA) was established in order to respect a precautionary limit dose (40 Gy) for the non-tumoral liver (NTL). BED was calculated setting α/ β = 2.5 Gy (NTL), 10 Gy (tumours); T 1/2,eff = T 1/2,phys = 64.2 h; T 1/2,rep = 2.5 h (NTL), 1.5 h (tumours). The BED to NTL was considered as a constraint for multi-cycle approach. The AA for two cycles and the percent variations of AA, tumour dose, BED were estimated. In one-cycle, for a prescribed BED to NTL of 64 Gy (NTL dose = 40 Gy), AA was 1.7 (0.9–3.2) GBq, tumour dose was 130 (65–235) Gy, and tumour BED was 170 (75–360) Gy. Considering two cycles, ∼15% increase was found for AA and dose to NTL, with unvaried BED for NTL. Tumour dose increase was 20 (10–35) Gy; tumour BED increase was 10 (3–11) Gy. In different protocols allowing 80 Gy to NTL, the BED sparing estimated was ∼50 Gy (two cycles) and 65 Gy (three cycles). From a radiobiological perspective, multi-cycle treatments would allow administering higher activities with increased tumour irradiation and preserved radiation effects on NTL. Trials comparing single vs. multiple cycles are suggested.
- Subjects
RADIOISOTOPE therapy; MICROSPHERES; LIVER disease treatment; RADIOTHERAPY; RADIOBIOLOGY
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2008, Vol 35, Issue 11, p2088
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-008-0857-3