Bernard Cheng1, Ila Sethi2, Neena Davisson3, David Brandon2, Bruce Barron2, James Galt2, Zachary Bercu3, David M Schuster2, Nima Kokabi3. 1. MD Student Program, Morehouse School of Medicine. 2. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University. 3. Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA.
Abstract
PURPOSE: The aim of the study was to evaluate the effects of tumour dose on tumour response and overall survival (OS) in patients with chemo-refractory metastatic breast cancer (MBC) to the liver undergoing yttrium-90 radioembolisation (Y90 RE). MATERIALS AND METHODS: In 20 consecutive patients with chemo-refractory MBC to the liver undergoing 33 total Y90 RE resin treatments, volumes of interest were drawn around the five largest tumours of the targeted liver lobe on post-Y90 RE Bremsstrahlung single-photon emission computed tomography/computed tomography using MIM software v.6.9 (MIM Software, Cleveland, Ohio, USA) and dose-volume histograms were calculated. Response Evaluation Criteria in Solid Tumours (RECIST) was used to determine tumour response at 3 months. Receiver operating characteristics (ROC) curves were used to determine thresholds for various dosimetry parameters. Kaplan-Meier estimation was used to determine OS. RESULTS: Overall, 11 of 33 (33%) Y90 RE treatments resulted in complete or partial response according to RECIST criteria with a median OS of 20.97 months compared to 11.73 months for nonresponders (P = 0.003). Mean tumour dose, defined as the aggregate tumour dose of up to the five largest tumours in the targeted lobe, was the most predictive of tumour response with the highest area under the ROC curve of 0.967. Mean tumour dose >70 Gy had 91% sensitivity and 100% specificity for predicting tumour response. Patients with mean tumour dose >70 Gy experienced a median OS of 16.1 months vs. 12.8 months for those who did not (P = 0.008). CONCLUSION: For patients with chemo-refractory breast cancer with liver metastases, achieving a mean tumour dose >70 Gy is a significant predictor of tumour response and prolonged OS.
PURPOSE: The aim of the study was to evaluate the effects of tumour dose on tumour response and overall survival (OS) in patients with chemo-refractory metastatic breast cancer (MBC) to the liver undergoing yttrium-90 radioembolisation (Y90 RE). MATERIALS AND METHODS: In 20 consecutive patients with chemo-refractory MBC to the liver undergoing 33 total Y90 RE resin treatments, volumes of interest were drawn around the five largest tumours of the targeted liver lobe on post-Y90 RE Bremsstrahlung single-photon emission computed tomography/computed tomography using MIM software v.6.9 (MIM Software, Cleveland, Ohio, USA) and dose-volume histograms were calculated. Response Evaluation Criteria in Solid Tumours (RECIST) was used to determine tumour response at 3 months. Receiver operating characteristics (ROC) curves were used to determine thresholds for various dosimetry parameters. Kaplan-Meier estimation was used to determine OS. RESULTS: Overall, 11 of 33 (33%) Y90 RE treatments resulted in complete or partial response according to RECIST criteria with a median OS of 20.97 months compared to 11.73 months for nonresponders (P = 0.003). Mean tumour dose, defined as the aggregate tumour dose of up to the five largest tumours in the targeted lobe, was the most predictive of tumour response with the highest area under the ROC curve of 0.967. Mean tumour dose >70 Gy had 91% sensitivity and 100% specificity for predicting tumour response. Patients with mean tumour dose >70 Gy experienced a median OS of 16.1 months vs. 12.8 months for those who did not (P = 0.008). CONCLUSION: For patients with chemo-refractory breast cancer with liver metastases, achieving a mean tumour dose >70 Gy is a significant predictor of tumour response and prolonged OS.
Authors: Richard Wu; Keerthi Gogineni; Jane Meisel; Stephen Szabo; Meenakshi Thirunavu; Sarah Friend; Zachary Bercu; Ila Sethi; Neela Natarajan; Jeffrey Switchenko; Jason Levy; Eddie Abdalla; Laura Weakland; Kevin Kalinsky; Nima Kokabi Journal: Cardiovasc Intervent Radiol Date: 2022-08-25 Impact factor: 2.797
Authors: Max Seidensticker; Matthias Philipp Fabritius; Jannik Beller; Ricarda Seidensticker; Andrei Todica; Harun Ilhan; Maciej Pech; Constanze Heinze; Maciej Powerski; Robert Damm; Alexander Weiss; Johannes Rueckel; Jazan Omari; Holger Amthauer; Jens Ricke Journal: Cancers (Basel) Date: 2021-04-21 Impact factor: 6.639
Authors: Elie Barakat; Andras Bibok; Anupam Rishi; Altan Ahmed; Jessica M Frakes; Sarah E Hoffe; Avan J Armaghani; Aixa E Soyano; Ricardo L B Costa; Ghassan El-Haddad; Junsung Choi; Bela Kis Journal: Adv Radiat Oncol Date: 2021-10-29