Direct injection of 188Re-microspheres in the treatment of hepatocellular carcinoma

Y.-Ch. Lin; S.-Ch. Tsai; G.-U. Hung; J.-Ch. Lee; Y.-S. Huang; W.-Y. Lin

doi:10.1055/s-0038-1625689

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2005; 44(03): 76-80
DOI: 10.1055/s-0038-1625689

Original Articles

Schattauer GmbH

Direct injection of ¹⁸⁸Re-microspheres in the treatment of hepatocellular carcinoma

Compared with traditional percutaneous ethanol injection: an animal studyDirekte Injektion von ¹⁸⁸Re-Mikrosphären zur Behandlung des LeberzellkarzinomsVergleich mit traditioneller Ethanolinjektion – eine tierexperimentelle Studie

Y.-Ch. Lin

¹Department of Veterinary Medicine, National Chung-Hsing University, Taichung Departments of Nuclear Medicine

,

S.-Ch. Tsai

²Show Chwan Memorial Hospital

,

G.-U. Hung

³Changhua Christian Hospital, Changhua

,

J.-Ch. Lee

¹Department of Veterinary Medicine, National Chung-Hsing University, Taichung Departments of Nuclear Medicine

,

Y.-S. Huang

¹Department of Veterinary Medicine, National Chung-Hsing University, Taichung Departments of Nuclear Medicine

,

W.-Y. Lin

⁴Taichung Veterans General Hospital, Taichung, Taiwan

› Author Affiliations

Abstract

Summary

The aim of this study was to compare the therapeutic efficacies of direct intratumoural injection of 188Re microspheres (DIRM) and direct intratumoural injection of ethanol (DIE) in rabbits bearing liver tumours. Materials and methods: Fifteen rabbits bearing liver tumours were divided into three groups: group 1 received DIE, group 2 received DIRM, and group 3 (control) received saline. Tumour size was measured by liver sonography before injection, as well as 2, 4, 8, and 12 weeks after injection. Survival time was calculated from the day of treatment to three months after treatment by Kaplan-Meier survival analysis. Results: The mean survival time was 68 ± 9.8 days for the rabbits in the DIRM group, 55.8 ± 11.8 days for the DIE group, and 38.8 ± 6.2 days for the control group. Conclusion: The rabbits survived longer in the DIRM group than in the DIE group although there is no statistical significance. We believe the DIRM method has a good potential to be an alternative to DIE for the treatment of liver tumours.

Zusammenfassung

Ziel der Studie war der Vergleich der therapeutischen Wirksamkeit der direkten intratumoralen Injektion von 188Re- Mikrosphären (DIRM) und der direkten intratumoralen Injektion von Ethanol (DIE) bei Kaninchen mit Lebertumoren. Materialien, Methoden: Fünfzehn Kaninchen mit Lebertumoren wurden drei Gruppen zugeordnet: Gruppe 1 erhielt DIE, Gruppe 2 DIRM und Gruppe 3 (Kontrolle) Kochsalzlösung. Die Tumorgröße wurde mittels Lebersonographie vor sowie 2, 4, 8 und 12 Wochen nach der Injektion gemessen. Die Überlebenszeit wurde anhand einer Kaplan-MeierÜberlebensanalyse vom Behandlungstag bis drei Monate nach der Behandlung errechnet. Ergebnisse: Die mittlere Überlebenszeit betrug bei den Kaninchen in der DIRMGruppe 68 ± 9,8 Tage, bei den Kaninchen in der DIEGruppe 55,8 ± 11,8 Tage und in der Kontrollgruppe 38,8 ± 6,2 Tage. Schlussfolgerung: Die Kaninchen in der DIRM-Gruppe überlebten länger als die Kaninchen in der DIE-Gruppe, wenngleich kein statistischer Unterschied besteht. Wir glauben, dass die DIRM-Methode ein gutes Potenzial als Alternative zur DIE für die Behandlung von Lebertumoren besitzt.

Keywords

Hepatocellular carcinoma - 188Re microspheres - ethanol injection

Schlüsselwörter

Leberzellkarzinom - 188Re-Mikrosphären - Ethanolinjektion

Full Text

References

References
1 Callahan AP, Rice DE, Knapp Jr FF. Availability of Re-188 from a tungsten-188/Re188 generator system for therapeutic applications. J Nucl Med 1987; 28: 657p.
2 Di-Stasi M, Buscarini L, Livraghi T. et al. PEI in the treatment of HCC. A multicentre survey of evaluation practices and complication rates. Scand J Gastroenterol 1997; 32: 1168-73.
3 Hasegawa S, Yamasaki N, Hiwaki T. et al. Factors that predict intrahepatic recurrence of hepatocellular carcinoma in 81 patients initially treated by percutaneous ethanol injection. Cancer 1999; 86: 1682-90.
4 Keng GH, Sundram FX. Radionuclide therapy of hepatocellular carcinoma. Ann Acad Med Singapore 2003; 32: 518-24.
5 Lin WY, Tsai SC, Hsieh JF. et al. Effects of Yttrium- 90 microspheres on liver tumor: comparison of intra-tumoral injection method and intra-arterial injection method. J Nucl Med 2000; 41: 1892-7.
6 Livraghi T, Bolondi L, Lazzaroni S. et al. DIE in the treatment of HCC in cirrhosis. Cancer 1992; 6: 925-9.
7 Madsen MT, Park CH, Thakur ML. Dosimetry of iodine-131 Ethiodol in the treatment of hepatoma. J Nucl Med 1988; 29: 1033-44.
8 Shiina S, Imamura M, Obi S. et al. Percutaneous ethanol injection therapy for small hepatocellular carcinoma. Jpn J Cancer Chemother 1996; 23: 835-9.
9 Shiina S, Tagawa K, Unuma T. et al. PEI therapy for HCC: A histopathological study. Cancer 1991; 68: 1524-30.
10 Shimada M, Maeda T, Saitoh A. et al. Needle track seeding after percutaneous ethanol injection therapy for small HCC. J Surg Oncol 1995; 58: 278-81.
11 Takayasu K, Shima Y, Muramatsu Y. et al. Hepatocellular carcinoma: Treatment with intraarterial iodized oil with and without chemotherapeutic agents. Radiology 1987; 162: 345-51.
12 Tian JH, Xu BX, Zhang JM. et al. Ultrasound-guided internal radiotherapy using Y-90 glass microsphere for liver malignancies. J Nucl Med 1996; 37: 958-63.
13 Varela M, Sala M, Llovet JM. et al. Treatment of hepatocellular carcinoma: Is there an optimal strategy?. Cancer Treat Rev 2003; 29: 99-104.
14 Wang SJ, Lin WY, Chen MN. et al. Intratumoral injection of Rhenium-188 microspheres into an animal model of hepatoma. J Nucl Med 1998; 39: 1752-7.