Intra-Arterial Rhenium-188 Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results of an IAEA-Sponsored Multination Study

Bernal, Patricia; Raoul, Jean‐Luc; Vidmar, Gaj; Sereegotov, Erdenechimeg; Sundram, F. X.; Kumar, Ajay; Jeong, Jae Min; Pusuwan, Pawana; Divgi, Chaitanya; Zanzonico, Pat; Stare, Janez; Buscombe, J. R.; Minh, Chau Trinh Thi; Saw, Maung Maung; Chen, Shao‐Liang; Ogbac, Ruben; Padhy, Ajit Kumar

doi:10.1016/j.ijrobp.2007.05.009

Cited by 70 publications

(41 citation statements)

References 19 publications

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“…a dose escalation study to find the optimum dose has been proposed. 14 two large-scale phase ii studies of 188 re-lipiodol for the treatment of HCC were conducted in developing countries 39,40 and included 93 and 185 patients with advanced disease. Both trials demonstrated that 188 re-lipiodol treatment is feasible and well tolerated.…”

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confidence: 99%

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

Raoul

Boucher

Rolland

et al. 2010

Nat Rev Gastroenterol Hepatol

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Hepatocellular carcinoma (HCC) is becoming an important public health concern. Current therapeutic options are limited and new treatments are therefore being developed. The intra-arterial treatment chemoembolization has limited efficacy and few prospects for further progress. One particularly promising, though little used, alternative to chemoembolization is radioembolization with iodine-131 ((131)I) or rhenium-188 labeled lipiodol or yttrium-90 labeled microspheres (glass or resin beads). Three randomized studies have proven the effectiveness of (131)I-lipiodol in patients with HCC-as adjuvant therapy after surgery, compared with chemoembolization, and also in patients who have portal vein thrombosis. Microspheres enable the delivery of high-dose radiation (>200 Gy) to the tumor while sparing the neighboring hepatic tissue from overexposure. Overall, the efficacy of radioembolization has been good and toxic effects have been low. These results are comparable to those obtained with chemoembolization but further improvement can be expected by combining radioembolization with standard chemotherapy or with targeted therapies, such as anti-angiogenic drugs.

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confidence: 99%

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

Raoul

Boucher

Rolland

et al. 2010

Nat Rev Gastroenterol Hepatol

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“…This radionuclide has a shorter half-life than 131 I but similar b-emissions, allowing the administration of higher initial activities. Both initial results and later follow-up data suggest an efficacy rate for 188 Re similar to 131 I-lipiodol but a lower cost (18). In a series of 185 patients with unresectable HCC treated across 7 developing nations, the mean overall survival was 256 d. Although the number of patients with PVT was not noted, the authors stated that the presence of cirrhosis, CLIP score, and Child-Pugh score were the best predictors of survival.…”

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confidence: 99%

Transarterial Injection of ¹³¹I-Lipiodol, Compared with Chemoembolization, in the Treatment of Unresectable Hepatocellular Cancer

Marelli¹,

Shusang²,

Buscombe³

et al. 2009

J Nucl Med

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“…21,34,[39][40][41][42] However, radionuclide administration via transcatheter arterial infusion has some disadvantages. The existence of arteriovenous shunts in tumors could lead to leakage of the radionuclides to the lung, which could result in pulmonary fibrosis.…”

Section: Y Ormentioning

confidence: 99%

Preparation and therapeutic evaluation of 188Re-thermogelling emulsion in rat model of hepatocellular carcinoma

Shih¹,

Lin²,

Yeh³

et al. 2014

IJN

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Radiolabeled Lipiodol ® (Guerbet, Villepinte, France) is routinely used in hepatoma therapy. The temperature-sensitive hydrogel polyethylene glycol-b-poly-DL-lactic acid-co-glycolic acid-b-polyethylene glycol triblock copolymer is used as an embolic agent and sustained drug release system. This study attempted to combine the polyethylene glycol-b-poly-DL-lactic acid-co-glycolic acid-b-polyethylene glycol hydrogel and radio-labeled Lipiodol to form a new radio-thermogelling emulsion, rhenium-188–N,N’-1,2-ethanediylbis-L-cysteine diethyl-ester dihydrochloride–Lipiodol/hydrogel ( 188 Re-ELH). The therapeutic potential of 188 Re-ELH was evaluated in a rodent hepatoma model. Rhenium-188 chelated with N,N’-1,2-ethanediylbis-L-cysteine diethyl-ester dihydrochloride was extracted with Lipiodol to obtain rhenium-188–N,N’-1,2-ethanediylbis-L-cysteine diethyl-ester dihydrochloride–Lipiodol ( 188 Re-EL), which was blended with the hydrogel in equal volumes to develop 188 Re-ELH. The 188 Re-ELH phase stability was evaluated at different temperatures. Biodistribution patterns and micro-single-photon emission computed tomography/computed tomography images in Sprague Dawley rats implanted with the rat hepatoma cell line N1-S1 were observed after in situ tumoral injection of ~3.7 MBq 188 Re-ELH. The therapeutic potential of 188 Re-EL (48.58±3.86 MBq/0.1 mL, n=12) was evaluated in a 2-month survival study using the same animal model. The therapeutic effects of 188 Re-ELH (25.52±4.64 MBq/0.1 mL, n=12) were evaluated and compared with those of 188 Re-EL. The responses were assessed by changes in tumor size and survival rates. The 188 Re-ELH emulsion was stable in the gel form at 25°C–35°C for >52 hours. Biodistribution data and micro-single-photon emission computed tomography/computed tomography images of the 188 Re-ELH group indicated that most activity was selectively observed in hepatomas. Long-term 188 Re-ELH studies have demonstrated protracted reductions in tumor volumes and positive effects on the survival rates (75%) of N1-S1 hepatoma-bearing rats. Conversely, the 2-month survival rate was 13% in the control sham group. Therapeutic responses differed significantly between the two groups ( P <0.005). Thus, the hydrogel enhanced the injection stability of 188 Re-EL in an animal hepatoma model. Given the synergistic results, direct 188 Re-ELH intratumoral injection is a potential therapeutic alternative for hepatoma treatment.

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Intra-Arterial Rhenium-188 Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results of an IAEA-Sponsored Multination Study

Cited by 70 publications

References 19 publications

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

Transarterial Injection of ¹³¹I-Lipiodol, Compared with Chemoembolization, in the Treatment of Unresectable Hepatocellular Cancer

Preparation and therapeutic evaluation of 188Re-thermogelling emulsion in rat model of hepatocellular carcinoma

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Intra-Arterial Rhenium-188 Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results of an IAEA-Sponsored Multination Study

Cited by 70 publications

References 19 publications

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

Transarterial Injection of 131I-Lipiodol, Compared with Chemoembolization, in the Treatment of Unresectable Hepatocellular Cancer

Preparation and therapeutic evaluation of 188Re-thermogelling emulsion in rat model of hepatocellular carcinoma

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Transarterial Injection of ¹³¹I-Lipiodol, Compared with Chemoembolization, in the Treatment of Unresectable Hepatocellular Cancer