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Vindya Abeysinghe, Siva Sundararajan, Luc Delriviere, Jonathan Tibballs
Unresectableintrahepaticcholangiocarcinoma has a very poor prognosis despite various treatment options. The case presented describes the diagnostic challenges of a young pregnant woman with unresectable cholangiocarcinoma. The current treatment options for cholangiocarcinoma have limited evidence and high recurrence rate. Given the young age of this patient, selective internal radiotherapy was trialled with traditional chemotherapy with a clinically significant result. This case highlights the delays when diagnosing cholangiocarcinoma in younger patients and the possibility of selective internal radiation therapy in combination with chemotherapy as a potential first-line treatment for a complete response in unresectable disease...
March 9, 2018: BMJ Case Reports
Ijin Joo, Hyo-Cheol Kim, Gyoung Min Kim, Jin Chul Paeng
Radioembolization using beta-emitting yttrium-90 microspheres is being increasingly used for the treatment of primary and metastatic liver cancers. It is a form of intra-arterial brachytherapy which delivers intense radiation to liver tumors with little embolic effect; this mode of action results in unique post-treatment imaging findings. It is important to understand these imaging findings to avoid misinterpretation of tumor response and to determine further management of the disease. Herein, we discuss the current concepts for assessing tumor response, common post-treatment imaging features, and associated complications following radioembolization...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Bruno Sangro, Carlo Ludovico Maini, Giuseppe Maria Ettorre, Roberto Cianni, Rita Golfieri, Daniele Gasparini, Samer Ezziddin, Philipp M Paprottka, Francesco Fiore, Mark Van Buskirk, Jose Ignacio Bilbao, Rita Salvatori, Emanuela Giampalma, Onelio Geatti, Kai Wilhelm, Ralf Thorsten Hoffmann, Francesco Izzo, Mercedes Iñarrairaegui, Carlo Urigo, Alberta Cappelli, Alessandro Vit, Hojjat Ahmadzadehfar, Tobias Franz Jakobs, Rosa Sciuto, Giuseppe Pizzi, Secondo Lastoria
PURPOSE: Radioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation. METHODS: This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received radioembolisation with yttrium-90 resin microspheres at eight European centres between September 2003 and December 2009...
March 7, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Pierce K H Chow, Mihir Gandhi, Say-Beng Tan, Maung Win Khin, Ariunaa Khasbazar, Janus Ong, Su Pin Choo, Peng Chung Cheow, Chanisa Chotipanich, Kieron Lim, Laurentius A Lesmana, Tjakra W Manuaba, Boon Koon Yoong, Aloysius Raj, Chiong Soon Law, Ian H Y Cua, Rolley R Lobo, Catherine S C Teh, Yun Hwan Kim, Yun Won Jong, Ho-Seong Han, Si-Hyun Bae, Hyun-Ki Yoon, Rheun-Chuan Lee, Chien-Fu Hung, Cheng-Yuan Peng, Po-Chin Liang, Adam Bartlett, Kenneth Y Y Kok, Choon-Hua Thng, Albert Su-Chong Low, Anthony S W Goh, Kiang Hiong Tay, Richard H G Lo, Brian K P Goh, David C E Ng, Ganesh Lekurwale, Wei Ming Liew, Val Gebski, Kenneth S W Mak, Khee Chee Soo
Purpose Selective internal radiation therapy or radioembolization (RE) shows efficacy in unresectable hepatocellular carcinoma (HCC) limited to the liver. This study compared the safety and efficacy of RE and sorafenib in patients with locally advanced HCC. Patients and Methods SIRveNIB (selective internal radiation therapy v sorafenib), an open-label, investigator-initiated, phase III trial, compared yttrium-90 (90 Y) resin microspheres RE with sorafenib 800 mg/d in patients with locally advanced HCC in a two-tailed study designed for superiority/detriment...
March 2, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Zhongzhi Jia, Weiping Wang
OBJECTIVE: To evaluate the value of yttrium-90 (90 Y) microspheres in the management of unresectable liver metastases secondary to neuroendocrine tumors (NETs). MATERIALS AND METHODS: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the "gray" literature (Google Scholar) were searched for all studies related to90 Y therapy for unresectable liver metastases of NETs. RESULTS: A total of 11 studies and 7 abstracts involving 870 patients were included in the final analysis...
March 2018: European Journal of Radiology
Jad Chahoud, Dawen Sui, William D Erwin, Alison M Gulbis, Martin Korbling, Mingzhi Zhang, Sairah Ahmed, Gheath Alatrash, Paolo Anderlini, Stefan O Ciurea, Betul Oran, Luis Fayad, Roland L Bassett, Elias Jabbour, L Jeffrey Medeiros, Homer A Macapinlac, Ken H Young, Issa F Khouri
PURPOSE: We evaluated the effect on long-term survival of adding rituximab (R) to BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning with or without yttrium-90 ibritumomab tiuxetan (90YIT) in patients with relapsed diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (ASCT). EXPERIMENTAL DESIGN: Patients were enrolled on three consecutive phase 2 clinical trials. Patients received two doses of rituximab (375 mg/m2 and 1000 mg/m2) during mobilization of stem cells, followed by 1000 mg/m2 on days +1 and +8 after ASCT with R-BEAM or 90YIT-R-BEAM (90YIT dose of 0...
February 23, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Soham D Puvvada, José M Guillén-Rodríguez, Jessica Yan, Lora Inclán, Kara Heard, Xavier I Rivera, Faiz Anwer, Daruka Mahadevan, Jonathan H Schatz, Daniel O Persky
BACKGROUND: Radioimmunotherapy (RIT) is effective in treating relapsed/refractory follicular lymphoma (FL), with durable remissions in first-line consolidation. We hypothesized that RIT with ibritumomab tiuxetan (Zevalin®) would result in durable remissions by eliminating minimal residual disease after cytoreduction. METHODS: Patients with FL received 2 cycles of ESHAP (etoposide, methylprednisolone, cytarabine, cisplatin) every 28 days, followed by Zevalin 4-6 weeks later if there was no disease progression and bone marrow biopsy showed < 25% involvement...
February 22, 2018: Oncology
Sebastian Mafeld, Jeremy French, Dina Tiniakos, Beate Haugk, Derek Manas, Peter Littler
We describe a 52-year-old female patient who presented with a 9.5-cm fibrolamellar hepatocellular carcinoma (FL-HCC). The patient was initially unsuitable for surgical resection and therefore underwent transarterial chemoembolization followed by selective internal radiation therapy (SIRT) with Yttrium-90 to downsize the tumour. Following SIRT, the tumour decreased in volume from 350 to 20 cm3 allowing curative (R0) resection with an extended left hepatectomy and reconstruction of IVC. This is the first reported case of FL-HCC treated with SIRT in which, due to the good SIRT response, the patient was downsized to allow curative resection...
February 21, 2018: Cardiovascular and Interventional Radiology
Mina S Makary, Lawrence S Krishner, Evan J Wuthrick, Mark P Bloomston, Joshua D Dowell
Adrenocortical carcinoma (ACC) is a rare malignancy with generally poor outcomes and limited treatment options. While surgical resection can be curative for early local disease, most patients present with advanced ACC owing to nonspecific symptoms. For those patients, treatment options include systemic chemotherapy and locoregional therapies including radiofrequency ablation and transarterial chemoembolization. We present the first reported case of utilizing yttrium-90 microsphere selective internal radiation therapy (SIRT) in combination with first line EDP-M (Etoposide, Doxorubicin, Cisplatin, Mitotane) chemotherapy and debulking surgical primary tumor resection for treatment of metastatic ACC...
February 10, 2018: World Journal of Clinical Oncology
Paloma Sangro, Idoia Bilbao, Nerea Fernández-Ros, Mercedes Iñarrairaegui, Javier Zulueta, J I Bilbao, Bruno Sangro
Sorafenib is a multi-kinase inhibitor and a vascular endothelial growth factor (VEGF) inhibitor approved to treat patients with advanced hepatocellular carcinoma, renal cell carcinoma and differentiated thyroid carcinoma. Its most common side effects are asthenia/fatigue, skin toxicity, diarrhea and arterial hypertension. Reported respiratory adverse reactions include dyspnea, cough, pleural effusion and hoarseness. The aim of this report is to describe for the first time the occurrence of pneumatocele in two patients treated with Sorafenib...
January 19, 2018: Oncotarget
Nariman Nezami, Nima Kokabi, Juan C Camacho, David M Schuster, Minzhi Xing, Hyun S Kim
INTRODUCTION: There are two different types of Y90 Microspheres, glass and resin, in the market for Y90 radioembolization (Y90-RE). This study aimed to investigate the dose of radiation delivered through glass vs. resin-based Y90-RE to intrahepatic cholangiocarcinoma (ICC). METHODS: In this retrospective study, 10 patients with ICC underwent Y90-RE, five underwent glass (Glass group) and other 5 resin (Resin group) microspheres. Technetium-99m macro-aggregated albumin (Tc-99m MAA) shunt study was performed two weeks before Y90-RE...
January 16, 2018: Nuclear Medicine and Biology
Valerie Chew, Yun Hua Lee, Lu Pan, Nurul J M Nasir, Chun Jye Lim, Camillus Chua, Liyun Lai, Sharifah Nur Hazirah, Tony Kiat Hon Lim, Brian K P Goh, Alexander Chung, Richard H G Lo, David Ng, Rene L F Filarca, Salvatore Albani, Pierce K H Chow
OBJECTIVES: Yttrium-90 (Y90)-radioembolisation (RE) significantly regresses locally advanced hepatocellular carcinoma and delays disease progression. The current study is designed to deeply interrogate the immunological impact of Y90-RE, which elicits a sustained therapeutic response. DESIGN: Time-of-flight mass cytometry and next-generation sequencing (NGS) were used to analyse the immune landscapes of tumour-infiltrating leucocytes (TILs), tumour tissues and peripheral blood mononuclear cells (PBMCs) at different time points before and after Y90-RE...
February 13, 2018: Gut
Paul Blanc-Durand, Axel Van Der Gucht, Mario Jreige, Marie Nicod-Lalonde, Marina Silva-Monteiro, John O Prior, Alban Denys, Adrien Depeursinge, Niklaus Schaefer
Purpose: To generate a predictive whole-liver radiomics scoring system for progression-free survival (PFS) and overall survival (OS) in patients undergoing transarterial radioembolization using Yttrium-90 ( 90 Y-TARE) for unresectable hepatocellular carcinoma (uHCC). Results: The generated pPET-RadScores were significantly correlated with survival for PFS (median of 11.4 mo [95% confidence interval CI: 6.3-16.5 mo] in low-risk group [PFS-pPET-RadScore < 0.09] vs...
January 12, 2018: Oncotarget
Adeel S Khan, Sandra Garcia-Aroz, Mohammad A Ansari, Syed M Atiq, Michael Senter-Zapata, Kathryn Fowler, M B Doyle, W C Chapman
Post hepatectomy liver failure (PHLF) remains a significant cause of morbidity and mortality after major liver resection. Although the etiology of PHLF is multifactorial, an inadequate functional liver remnant (FLR) is felt to be the most important modifiable predictor of PHLF. Pre-operative evaluation of FLR function and volume is of paramount importance before proceeding with any major liver resection. Patients with inadequate or borderline FLR volume must be considered for volume optimization strategies such as portal vein embolization (PVE), two stage hepatectomy with portal vein ligation (PVL), Yttrium-90 radioembolization, and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)...
February 6, 2018: International Journal of Surgery
Jong Min Kim, Wi Song Kim, Yong Pak
For radiosynovectomy, we have measured the retention time of yttrium-90 (90Y) hydroxyapatite (particle size 1-10 μm) within the knee joint space and evaluated the treatment responses in knees with rheumatoid arthritis. Radioactive measurements in the region of knee after injection of 90Y hydroxyapatite into the joint space were made with a single prove system designed to monitor radioactivity and showed retention of 90Y in the knee ranged 76.6% ±5.4% after 4 days of injection. The clinical improvements in rheumatoid arthritis of knee joint with steinbroker Stages I and II were increased as time goes by, the improvement ratio is in 72% at 6th months and 76% at 12th months after injection of 90Y 185 MBq (5 mCi) per joint...
January 2018: World Journal of Nuclear Medicine
P Reimer, M K Virarkar, M Binnenhei, C Justinger, M R Schön, K Tatsch
The published article has an error in the first name initial of one of the authors. "M. Justinger" should be "C. Justinger" as shown in this erratum.
January 29, 2018: Cardiovascular and Interventional Radiology
Hyo-Cheol Kim, Yoon Jun Kim, Jin Chul Paeng, Jin Wook Chung
PURPOSE: To address the feasibility of infusion of yttrium-90 (90Y) glass microspheres directly through the right inferior phrenic artery (RIPA). MATERIALS AND METHODS: From November 2015 to May 2017, 20 patients underwent 90Y radioembolization through the RIPA. When the systemic-to-pulmonary shunt was demonstrated on C-arm computed tomography (CT) of the RIPA, prophylactic embolization by polyvinyl alcohol (PVA) particles was performed prior to infusion of 90Y glass microspheres...
January 17, 2018: Journal of Vascular and Interventional Radiology: JVIR
Kin Man Au, Ashutosh Tripathy, Carolina Pe-I Lin, Kyle Wagner, Seungpyo Hong, Andrew Z Wang, Steven I Park
Non-Hodgkin lymphoma (NHL) is one of the most common types of hematologic malignancies. Pretargeted radioimmunotherapy (PRIT), the sequential administration of a bispecific antibody-based primary tumor-targeting component followed by a radionucleotide-labeled treatment effector, has been developed to improve the treatment efficacy and to reduce the side effects of conventional RIT. Despite the preclinical success of PRIT, clinical trials revealed that the immunogenicity of the bispecific antibody as well as the presence of competing endogenous effector molecules often compromised the treatment...
January 23, 2018: ACS Nano
Charlotte A Porter, Kevin M Bradley, Eero T Hippeläinen, Matthew D Walker, Daniel R McGowan
BACKGROUND: Post-therapy SPECT/CT imaging of 90Y microspheres delivered to hepatic malignancies is difficult, owing to the continuous, high-energy Bremsstrahlung spectrum emitted by 90Y. This study aimed to evaluate the utility of a commercially available software package (HybridRecon, Hermes Medical Solutions AB) which incorporates full Monte Carlo collimator modelling. Analysis of image quality was performed on both phantom and clinical images in order to ultimately provide a recommendation of an optimum reconstruction for post-therapy 90Y microsphere SPECT/CT imaging...
January 22, 2018: EJNMMI Research
Gamze Türk, Gonca Eldem, Saadettin Kılıçkap, Fani Murat Bozkurt, Bilge Volkan Salancı, Barbaros Erhan Çil, Bora Peynircioğlu, Şuayip Yalçın, Ferhun Balkancı
PURPOSE: We aimed to evaluate the efficacy and outcomes of radioembolization with Yttrium-90 (Y-90) microspheres in patients with unresectable and chemorefractory colorectal cancer liver metastasis (CRCLM). METHODS: This single-center study included 43 patients (34 male, 9 female) who underwent radioembolization with Y-90 for unresectable, chemorefractory CRCLM between September 2008 and July 2014. Overall survival (OS), liver progression-free survival (LPFS), overall response rate (ORR), local disease control rate (LDCR), and relations of these parameters with patient disease characteristics were evaluated...
January 22, 2018: Journal of Gastrointestinal Cancer
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