Abstract | UNLABELLED: One approach to treatment of primary hepatocellular carcinoma (HCC) is intraarterial injection of (131)I-lipiodol. Although clinical results have been positive, the therapy can be improved by using (188)Re instead of (131)I as the radionuclide. (188)Re is a high-energy beta-emitter, has a shorter half-life than (131)I, and has only low-intensity gamma-rays in its decay. The present study compared the cytotoxic effect of the radionuclide therapy in HCC patients treated with (131)I-lipiodol and (188)Re-4-hexadecyl 2,2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol (HDD)/ lipiodol. To this end, dicentric chromosomes (DCs) were scored in metaphase spreads of peripheral blood cultures. The equivalent total-body dose was deduced from the DC yields using an in vitro dose-response curve. METHODS: Twenty (131)I-lipiodol treatments and 11 (188)Re-HDD/ lipiodol treatments were performed on, respectively, 16 and 7 patients with inoperable HCC. Patients received a mean activity of 1.89 GBq of (131)I-lipiodol or 3.56 GBq of (188)Re-HDD/ lipiodol into the liver artery by catheterization. For each patient, a blood sample was taken during the week before therapy. A blood sample was also taken 7 and 14 d after administration for the patients treated with (131)I-lipiodol and 1 or 2 d after administration for the patients treated with (188)Re-HDD/ lipiodol. RESULTS: The mean DC yield of (188)Re-HDD/ lipiodol therapy (0.087 DCs per cell) was significantly lower than that of (131)I-lipiodol therapy (0.144 DCs per cell) for the administered activities. Corresponding equivalent total-body doses were 1.04 Gy for (188)Re-HDD/ lipiodol and 1.46 Gy for (131)I-lipiodol. Data analysis showed that, in comparison with (131)I-lipidol, (188)Re-HDD/ lipiodol yielded a smaller cytotoxic effect and a lower radiation exposure for an expected higher tumor-killing effect. CONCLUSION: (188)Re is a valuable alternative for (131)I in the treatment of HCC with radiolabeled lipiodol, and a dose escalation study for (188)Re-HDD/ lipiodol therapy is warranted.
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Authors | Kim De Ruyck, Bieke Lambert, Klaus Bacher, Filip Gemmel, Filip De Vos, Anne Vral, Leo de Ridder, Rudi A Dierckx, Hubert Thierens |
Journal | Journal of nuclear medicine : official publication, Society of Nuclear Medicine
(J Nucl Med)
Vol. 45
Issue 4
Pg. 612-8
(Apr 2004)
ISSN: 0161-5505 [Print] United States |
PMID | 15073257
(Publication Type: Clinical Trial, Clinical Trial, Phase I, Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Iodine Radioisotopes
- Radioisotopes
- Rhenium
- Iodized Oil
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Topics |
- Adult
- Aged
- Body Burden
- Carcinoma, Hepatocellular
(blood, genetics, pathology, radiotherapy)
- Chromosome Aberrations
(radiation effects)
- Chromosomes
(radiation effects)
- Cohort Studies
- Dose-Response Relationship, Radiation
- Female
- Humans
- Iodine Radioisotopes
(adverse effects, blood, therapeutic use)
- Iodized Oil
(adverse effects, pharmacokinetics, therapeutic use)
- Liver Neoplasms
(blood, genetics, metabolism, radiotherapy)
- Lymphocytes
(pathology, radiation effects)
- Male
- Middle Aged
- Radiation Injuries
(etiology)
- Radioisotopes
(adverse effects, blood, therapeutic use)
- Radiometry
(methods)
- Relative Biological Effectiveness
- Rhenium
(adverse effects, blood, therapeutic use)
- Whole-Body Counting
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