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J Nucl Med. 2008; 49 (Supplement 1):103P
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Oncology-Basic Science: Therapy, Metrics & Intervention

Clinical Radionuclide Therapy

Efficacy of 90Y radiomicrosphere and chemotherapy combination treatment in patients with colorectal cancer liver metastases

Seza Gulec1, Michael Hall1, Heather Atkinson1, Geraldine Mesoloras1 and Kenneth Pennington1

1 Center for Cancer Care, Goshen, Indiana

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Objectives: To determine the relative efficacy of 90Y radiomicrosphere therapy (RMT) plus standard chemotherapy (chemo-RMT) compared to chemotherapy alone in patients with colorectal cancer liver metastases (CRCLM).

Methods: This is a phase II trial involving patients with bilobar hepatic metastases. 90Y resin microspheres were administered in a lobar fashion with the first course of FOLFOX-6 or FOLFIRI chemo. The selected lobe represented chemo-RMT treatment field, whereas the contralateral lobe represented the chemo-alone treatment field. Administered activity was determined using MIRD methodology. Clinical and dosimetric evaluations included 18F FDG-PET/CT and 99mTc MAA liver SPECT. Functional and anatomic tumor volumes (VF and VA) were determined in both chemo-RMT and chemo-alone treatment fields pre and post treatment.

Results: Fifteen patients have been enrolled. Mean tumor absorbed dose was 137 Gy. Mean liver absorbed dose was 39 Gy. All tumors in chemo-RMT treated lobes showed a decrease in VF and VA. Mean percent decreases in VF for chemo-RMT and chemo-alone treated fields were 86% and 35% respectively. Mean percent decreases in VA for chemo-RMT and chemo-alone treated fields were 59% and 22% respectively. A VF decrease of >90% (complete metabolic response) was observed in 73% of chemo-RMT and 40% of chemo-alone treatment fields. No disease progression was observed in the chemo-RMT treated fields, whereas 27% of the chemo-alone treated fields showed disease progression during the course of therapy. Changes in VF preceded the changes in VA, documented as early as 4 weeks (4 vs. 8-12 weeks).

Conclusions: Chemo-RMT demonstrated superior objective tumor responses, as determined by decrease in VF and VA, in comparison to chemo-alone in patients with CRCLM treated in a frontline setting.





This Article
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Right arrow Articles by Gulec, S.
Right arrow Articles by Pennington, K.
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Right arrow Articles by Gulec, S.
Right arrow Articles by Pennington, K.