Abstract:
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Purpose: Aim of the study was to investigate the safety profile and anti-tumor efficacy of loco-regional administration of colloidal yttrium-90 in brain tumors. We postulated that the treatment efficacy is related to the distribution of the radio-colloid in to the tumor bed instead of being related to specific targeting.
Methods and Materials: Written informed consent for the radionuclide treatment was obtained from all patients. We treated 3 patients affected by grade IV glioblastoma multiforme (GBM) and 2 by astrocitoma (ACT). All patients underwent standard surgical and radiotherapy treatment and have no alternative therapeutic options. The intrathecal catheter was implanted during the main surgical procedure in 1 patient and with a dedicated procedure in 4 patients. One patient had a cystic lesion. In order to verify the absence of a significant leakage from the resection cavity, patients were injected with 99mTc-colloid. The acquisition time after intrathecal administration was prolonged for at least 24 hours. The injected activity of 90Y-colloid for each treatment ranged from 185 to 399 MBq. Three patients received 1 administration, 1 patient had 2 treatments, and 1 had 4 treatments. The maximum cumulative administered activity was 1160 MBq in the patient who received four cycles. Toxicity and adverse effects were evaluated by objective examination and hematological parameters. The objective response was evaluated with MR or/and CT before and 8 weeks after the treatment.
Results: In all patients, pre-treatment images demonstrated no radiopharmaceutical leakage from the surgical cavity. The treatment was well tolerated without acute side effects. None of the patients developed hematological and/or neurological toxicity. Three patients affected by GBM received only one administration and have disease progression at 1 to 3 months after the treatment. One patient with ACT had 2 treatments and stable disease after 13 months. The other ACT patient had four treatments and stable disease after 6 months.
Conclusion: These preliminary data suggest intrathecal radiotherapy with low activity of 90Y-colloid is safe and may be effective in selected patients. Based on this results further studies employing 90Y-colloid could be justified.
Questions about this event email: arturo.chiti@humanitas.it
Chiti MD, A,
Yttrium-90 Colloid as a Tool for Intra-tecal Radiotherapy in Brain Tumors. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103172.html
