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Author Notes:

nkokabi@emory.edu; Tel.: +1-404-686-8715; Fax: +1-404-686-0104

Conceptualization, N.K.; Methodology, N.K.; Software, B.C.; Validation, N.K.; Formal Analysis, N.K.; Investigation, B.C., I.S., Z.B., D.B., B.M., D.M.S.; Resources, N.K.; Data Curation, N.K.; Writing—Original Draft Preparation, T.S.; Writing—Review and Editing, T.S., B.C., N.N., M.X., N.K., I.S., Z.B., D.B., B.M., D.M.S.; Visualization, B.C., N.N., N.K.; Supervision, N.K.; Project Administration, N.K. All authors have read and agreed to the published version of the manuscript.

Nima Kokabi conducts research partially funded by Sirtex Medical Ltd. Nima Kokabi holds an educational grant from Boston Scientific. The remaining authors declare no conflict of interest.

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Research Funding:

This research received no external funding.

Keywords:

  • objective tumor response
  • overall survival
  • selective internal radiation therapy
  • treatment related toxicity
  • unresectable colorectal liver metastasis

Role of resin microsphere y90 dosimetry in predicting objective tumor response, survival and treatment related toxicity in surgically unresectable colorectal liver metastasis: A retrospective single institution study

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Journal Title:

Cancers

Volume:

Volume 13, Number 19

Publisher:

Type of Work:

Article | Final Publisher PDF

Abstract:

Purpose: To Evaluate the correlation between tumor dosimetric parameters with objective tumor response (OR) and overall survival (OS) in patients with surgically unresectable colorectal liver metastasis (CRLM) undergoing resin-based Ytrrium-90 selective internal radiation therapy (Y90 SIRT). Materials and Methods: 45 consecutive patients with CRLM underwent resin-based Y90 SIRT in one or both hepatic lobes (66 treated lobes total). Dose volume histograms were created with MIM Sureplan® v.6.9 using post-treatment SPECT/CT. Dosimetry analyses were based on the cumulative volume of the five largest tumors in each treatment session and non-tumoral liver (NTL) dose. Receiver operating characteristic (ROC) curve was used to evaluate tumor dosimetric factors in predicting OR by Response Evaluation Criteria for Solid Tumors at 3 months post-Y90. Additionally, ROC curve was used to evaluate non-tumoral liver dose as a predictor of grade ≥3 liver toxicity and radioembolization induced liver disease (REILD) 3 months post Y90. To minimize for potential confounding demographic and clinical factors, univariate and multivariate analysis of survival with mean tumor dose as one of the factors were also performed. Kaplan-Meier estimation was used for OS analysis from initial Y90 SIRT. Results: 26 out of 45 patients had OR with a median OS of 17.2 months versus 6.8 months for patients without OR (p < 0.001). Mean tumor dose (TD) of the five largest tumors was the strongest predictor of OR with an area under the curve of 0.73 (p < 0.001). Minimum TD, and TD to 30%, 50%, and 70% of tumor volume also predicted OR (p’s < 0.05). Mean TD ≥ 100 Gy predicted a significantly prolonged median OS of 19 vs. 11 months for those receiving.

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© 2021 by the authors

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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