International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results With Special Emphasis on Prognostic Value of Dosimetric Study

Patricia Bernal, Jean Luc Raoul, Janez Stare, Erdenechimeg Sereegotov, Felix X. Sundram, Ajay Kumar, Jae Min Jeong, Pawana Pusuwan, Chaitanya Divgi, Pat Zanzonico, Gaj Vidmar, John Buscombe, Trinh Thi Minh Chau, Maung Maung Saw, Shaoliang Chen, Ruben Ogbac, Maurizio Dondi, Ajit Kumar Padhy

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Abstract

A multicenter study was sponsored by the International Atomic Energy Agency (IAEA) to assess the safety and efficacy of transarterial rhenium-188 (188Re) HDD lipiodol (radioconjugate to lipiodol using an HDD kit) in the treatment of unresectable hepatocellular carcinoma. During 5 years, 185 patients received at least 1 treatment of radioconjugate, and 51 were retreated. The level of radioconjugate administered was based on radiation-absorbed dose to critical normal organs, calculated after a "scout" dose of radioconjugate. The total injected activity, including the scout dose during the first treatment, ranged from 21 to 364 mCi (mean, 108 mCi/4 GBq). Immediate and late side-effects were minimal. Tumor size could be evaluated in 88 patients. Among these patients, the objective response rate was 25%; stable disease was observed in 53% and tumor progression in 22%. With a median follow-up of 455 days, the estimated 12- and 24-month overall survival was 46% and 23%. This multicenter study shows that 188Re lipiodol is a safe and cost-effective method to treat primary hepatocellular carcinoma via the transarterial route and requires further evaluation by treatment of greater numbers of patients.

Original languageEnglish
Pages (from-to)S40-S45
JournalSeminars in Nuclear Medicine
Volume38
Issue number2
DOIs
StatePublished - 1 Mar 2008

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Rhenium
Nuclear Energy
Ethiodized Oil
Hepatocellular Carcinoma
Multicenter Studies
Therapeutics
Neoplasms
Radiation
Safety
Costs and Cost Analysis
Survival

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Bernal, Patricia ; Raoul, Jean Luc ; Stare, Janez ; Sereegotov, Erdenechimeg ; Sundram, Felix X. ; Kumar, Ajay ; Jeong, Jae Min ; Pusuwan, Pawana ; Divgi, Chaitanya ; Zanzonico, Pat ; Vidmar, Gaj ; Buscombe, John ; Chau, Trinh Thi Minh ; Saw, Maung Maung ; Chen, Shaoliang ; Ogbac, Ruben ; Dondi, Maurizio ; Padhy, Ajit Kumar. / International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma : Results With Special Emphasis on Prognostic Value of Dosimetric Study. In: Seminars in Nuclear Medicine. 2008 ; Vol. 38, No. 2. pp. S40-S45.
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abstract = "A multicenter study was sponsored by the International Atomic Energy Agency (IAEA) to assess the safety and efficacy of transarterial rhenium-188 (188Re) HDD lipiodol (radioconjugate to lipiodol using an HDD kit) in the treatment of unresectable hepatocellular carcinoma. During 5 years, 185 patients received at least 1 treatment of radioconjugate, and 51 were retreated. The level of radioconjugate administered was based on radiation-absorbed dose to critical normal organs, calculated after a {"}scout{"} dose of radioconjugate. The total injected activity, including the scout dose during the first treatment, ranged from 21 to 364 mCi (mean, 108 mCi/4 GBq). Immediate and late side-effects were minimal. Tumor size could be evaluated in 88 patients. Among these patients, the objective response rate was 25{\%}; stable disease was observed in 53{\%} and tumor progression in 22{\%}. With a median follow-up of 455 days, the estimated 12- and 24-month overall survival was 46{\%} and 23{\%}. This multicenter study shows that 188Re lipiodol is a safe and cost-effective method to treat primary hepatocellular carcinoma via the transarterial route and requires further evaluation by treatment of greater numbers of patients.",
author = "Patricia Bernal and Raoul, {Jean Luc} and Janez Stare and Erdenechimeg Sereegotov and Sundram, {Felix X.} and Ajay Kumar and Jeong, {Jae Min} and Pawana Pusuwan and Chaitanya Divgi and Pat Zanzonico and Gaj Vidmar and John Buscombe and Chau, {Trinh Thi Minh} and Saw, {Maung Maung} and Shaoliang Chen and Ruben Ogbac and Maurizio Dondi and Padhy, {Ajit Kumar}",
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Bernal, P, Raoul, JL, Stare, J, Sereegotov, E, Sundram, FX, Kumar, A, Jeong, JM, Pusuwan, P, Divgi, C, Zanzonico, P, Vidmar, G, Buscombe, J, Chau, TTM, Saw, MM, Chen, S, Ogbac, R, Dondi, M & Padhy, AK 2008, 'International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results With Special Emphasis on Prognostic Value of Dosimetric Study', Seminars in Nuclear Medicine, vol. 38, no. 2, pp. S40-S45. https://doi.org/10.1053/j.semnuclmed.2007.10.006

International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma : Results With Special Emphasis on Prognostic Value of Dosimetric Study. / Bernal, Patricia; Raoul, Jean Luc; Stare, Janez; Sereegotov, Erdenechimeg; Sundram, Felix X.; Kumar, Ajay; Jeong, Jae Min; Pusuwan, Pawana; Divgi, Chaitanya; Zanzonico, Pat; Vidmar, Gaj; Buscombe, John; Chau, Trinh Thi Minh; Saw, Maung Maung; Chen, Shaoliang; Ogbac, Ruben; Dondi, Maurizio; Padhy, Ajit Kumar.

In: Seminars in Nuclear Medicine, Vol. 38, No. 2, 01.03.2008, p. S40-S45.

Research output: Contribution to journalArticle

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T1 - International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma

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AU - Bernal, Patricia

AU - Raoul, Jean Luc

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AU - Sundram, Felix X.

AU - Kumar, Ajay

AU - Jeong, Jae Min

AU - Pusuwan, Pawana

AU - Divgi, Chaitanya

AU - Zanzonico, Pat

AU - Vidmar, Gaj

AU - Buscombe, John

AU - Chau, Trinh Thi Minh

AU - Saw, Maung Maung

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AU - Dondi, Maurizio

AU - Padhy, Ajit Kumar

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N2 - A multicenter study was sponsored by the International Atomic Energy Agency (IAEA) to assess the safety and efficacy of transarterial rhenium-188 (188Re) HDD lipiodol (radioconjugate to lipiodol using an HDD kit) in the treatment of unresectable hepatocellular carcinoma. During 5 years, 185 patients received at least 1 treatment of radioconjugate, and 51 were retreated. The level of radioconjugate administered was based on radiation-absorbed dose to critical normal organs, calculated after a "scout" dose of radioconjugate. The total injected activity, including the scout dose during the first treatment, ranged from 21 to 364 mCi (mean, 108 mCi/4 GBq). Immediate and late side-effects were minimal. Tumor size could be evaluated in 88 patients. Among these patients, the objective response rate was 25%; stable disease was observed in 53% and tumor progression in 22%. With a median follow-up of 455 days, the estimated 12- and 24-month overall survival was 46% and 23%. This multicenter study shows that 188Re lipiodol is a safe and cost-effective method to treat primary hepatocellular carcinoma via the transarterial route and requires further evaluation by treatment of greater numbers of patients.

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