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(90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer

BACKGROUND: The aim of this work was to confirm that post-selective internal radiation therapy (SIRT) (90)Y-PET/CT-based dosimetry correlates with lesion metabolic response and to determine its correlation with overall survival (OS) in liver-only metastases from colorectal cancer (mCRC) patients tre...

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Autores principales: Levillain, Hugo, Duran Derijckere, Ivan, Marin, Gwennaëlle, Guiot, Thomas, Vouche, Michaël, Reynaert, Nick, Hendlisz, Alain, Vanderlinden, Bruno, Flamen, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045565/
https://www.ncbi.nlm.nih.gov/pubmed/30006851
http://dx.doi.org/10.1186/s13550-018-0419-z
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author Levillain, Hugo
Duran Derijckere, Ivan
Marin, Gwennaëlle
Guiot, Thomas
Vouche, Michaël
Reynaert, Nick
Hendlisz, Alain
Vanderlinden, Bruno
Flamen, Patrick
author_facet Levillain, Hugo
Duran Derijckere, Ivan
Marin, Gwennaëlle
Guiot, Thomas
Vouche, Michaël
Reynaert, Nick
Hendlisz, Alain
Vanderlinden, Bruno
Flamen, Patrick
author_sort Levillain, Hugo
collection PubMed
description BACKGROUND: The aim of this work was to confirm that post-selective internal radiation therapy (SIRT) (90)Y-PET/CT-based dosimetry correlates with lesion metabolic response and to determine its correlation with overall survival (OS) in liver-only metastases from colorectal cancer (mCRC) patients treated with SIRT. Twenty-four mCRC patients underwent pre/post-SIRT FDG-PET/CT and post-SIRT (90)Y-PET/CT. Lesions delineated on pre/post-SIRT FDG-PET/CT were classified as non-metabolic responders (total lesion glycolysis (TLG)-decrease < 15%) and high-metabolic responders (TLG-decrease ≥ 50%). Lesion delineations were projected on the anatomically registered (90)Y-PET/CT. Voxel-based 3D dosimetrywas performed on the (90)Y-PET/CT and lesions’ mean absorbed dose (Dmean) was measured. The coefficient of correlation between Dmean and TLG-decrease was calculated. The ability of lesion Dmean to predict non-metabolic response and high-metabolic response was tested and two cutoff values (Dmean-under-treated and Dmean-well-treated) were determined using ROC analysis. Patients were dichotomised in the “treated” group (all the lesions received a Dmean > Dmean-under-treated) and in the “under-treated” group (at least one lesion received a Dmean < Dmean-under-treated). Kaplan-Meier product limit method was used to describe OS curves. RESULTS: Fifty-seven evaluable mCRC lesions were included. The coefficient of correlation between Dmean and TLG-decrease was 0.82. Two lesion Dmean cutoffs of 39 Gy (sensitivity 80%, specificity 95%, predictive-positive-value 86% and negative-predictive-value 92%) and 60 Gy (sensitivity 70%, specificity 95%, predictive positive-value 96% and negative-predictive-value 63%) were defined to predict non-metabolic response and high-metabolic response respectively. Patients with all lesions Dmean> 39 Gy had a significantly longer OS (13 months) than patients with at least one lesion Dmean < 39 Gy (OS = 5 months) (p = 0.012;hazard-ratio, 2.6 (95% CI 0.98–7.00)). CONCLUSIONS: In chemorefractory mCRC patients treated with SIRT, lesion Dmean determined on post-SIRT (90)Y-PET/CT correlates with metabolic response and higher lesion Dmean is associated with prolonged OS.
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spelling pubmed-60455652018-07-30 (90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer Levillain, Hugo Duran Derijckere, Ivan Marin, Gwennaëlle Guiot, Thomas Vouche, Michaël Reynaert, Nick Hendlisz, Alain Vanderlinden, Bruno Flamen, Patrick EJNMMI Res Original Research BACKGROUND: The aim of this work was to confirm that post-selective internal radiation therapy (SIRT) (90)Y-PET/CT-based dosimetry correlates with lesion metabolic response and to determine its correlation with overall survival (OS) in liver-only metastases from colorectal cancer (mCRC) patients treated with SIRT. Twenty-four mCRC patients underwent pre/post-SIRT FDG-PET/CT and post-SIRT (90)Y-PET/CT. Lesions delineated on pre/post-SIRT FDG-PET/CT were classified as non-metabolic responders (total lesion glycolysis (TLG)-decrease < 15%) and high-metabolic responders (TLG-decrease ≥ 50%). Lesion delineations were projected on the anatomically registered (90)Y-PET/CT. Voxel-based 3D dosimetrywas performed on the (90)Y-PET/CT and lesions’ mean absorbed dose (Dmean) was measured. The coefficient of correlation between Dmean and TLG-decrease was calculated. The ability of lesion Dmean to predict non-metabolic response and high-metabolic response was tested and two cutoff values (Dmean-under-treated and Dmean-well-treated) were determined using ROC analysis. Patients were dichotomised in the “treated” group (all the lesions received a Dmean > Dmean-under-treated) and in the “under-treated” group (at least one lesion received a Dmean < Dmean-under-treated). Kaplan-Meier product limit method was used to describe OS curves. RESULTS: Fifty-seven evaluable mCRC lesions were included. The coefficient of correlation between Dmean and TLG-decrease was 0.82. Two lesion Dmean cutoffs of 39 Gy (sensitivity 80%, specificity 95%, predictive-positive-value 86% and negative-predictive-value 92%) and 60 Gy (sensitivity 70%, specificity 95%, predictive positive-value 96% and negative-predictive-value 63%) were defined to predict non-metabolic response and high-metabolic response respectively. Patients with all lesions Dmean> 39 Gy had a significantly longer OS (13 months) than patients with at least one lesion Dmean < 39 Gy (OS = 5 months) (p = 0.012;hazard-ratio, 2.6 (95% CI 0.98–7.00)). CONCLUSIONS: In chemorefractory mCRC patients treated with SIRT, lesion Dmean determined on post-SIRT (90)Y-PET/CT correlates with metabolic response and higher lesion Dmean is associated with prolonged OS. Springer Berlin Heidelberg 2018-07-13 /pmc/articles/PMC6045565/ /pubmed/30006851 http://dx.doi.org/10.1186/s13550-018-0419-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Levillain, Hugo
Duran Derijckere, Ivan
Marin, Gwennaëlle
Guiot, Thomas
Vouche, Michaël
Reynaert, Nick
Hendlisz, Alain
Vanderlinden, Bruno
Flamen, Patrick
(90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer
title (90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer
title_full (90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer
title_fullStr (90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer
title_full_unstemmed (90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer
title_short (90)Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer
title_sort (90)y-pet/ct-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045565/
https://www.ncbi.nlm.nih.gov/pubmed/30006851
http://dx.doi.org/10.1186/s13550-018-0419-z
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