Whole brain radiotherapy for the treatment of multiple brain metastases

Tsao, May; Lloyd, Nancy; Wong, Rebecca; Chow, Edward; Rakovitch, Eileen; Laperrière, Normand

doi:10.1002/14651858.cd003869.pub2

Cited by 70 publications

(49 citation statements)

References 42 publications

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“…For multiple brain metastases, whole brain irradiation and stereotactic radiosurgery are the only therapeutic measures currently available (21)(22)(23)(24)(25). Whole brain radiotherapy (WBRT) is usually delivered in 10 fractions of 3 Gy (total dose: 30 Gy; ref.…”

Section: Introductionmentioning

confidence: 99%

Radretumab Radioimmunotherapy in Patients with Brain Metastasis: A 124I-L19SIP Dosimetric PET Study

Poli

Bianchi

Virotta

et al. 2013

Cancer Immunology Research

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Radioimmunotherapy (RIT) with 131 I-labeled L19SIP (radretumab; a small immunoprotein format antibody directed against the ED-B domain of fibronectin; $80 kDa molecular weight) has been investigated in several clinical trials. Here, we describe the use of immuno-PET imaging with iodine-124 ( 124 I)-labeled L19SIP to predict doses delivered to tumor lesions and healthy organs by a subsequent radretumab RIT in patients with brain metastases from solid cancer. Bone marrow doses were evaluated both during the diagnostic phase and posttherapy, measuring activities in blood (germanium detector) and whole body (lanthanum bromide detector). Expected doses for radretumab administration (4,107 MBq/m 2 ) were calculated from data obtained after administration of an average of 167 MBq 124 I-L19SIP to 6 patients. To assess lesion average doses, the positron emission tomography (PET) scanner was calibrated for the use of 124 I with an International Electrotechnical Commission (IEC) Body Phantom and recovery coefficients were calculated. The average dose to bone red marrow was 0.21 Gy/GBq, with high correlation between provisional and actual posttherapy doses. Although the fraction of injected activity in normal organs was similar in different patients, the antibody uptake in the neoplastic lesions varied by as much as a factor of 60. Immuno-PET with 124 I-labeled L19SIP offers significant advantages over conventional 131 I imaging, in particular accuracy of dosimetric results. Furthermore, the study indicates that antibody uptake can be highly variable even in different lesions of the same patient and that immuno-PET procedures may guide product development with armed antibodies. Cancer Immunol Res; 1(2); 134-43. Ó2013 AACR.

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Section: Introductionmentioning

confidence: 99%

Radretumab Radioimmunotherapy in Patients with Brain Metastasis: A 124I-L19SIP Dosimetric PET Study

Poli

Bianchi

Virotta

et al. 2013

Cancer Immunology Research

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“…This fact has already been shown by the multiple RTOG dose-finding trials in the 1970s and 1980s [4,5], the Royal College of Radiologists' publication from 1996 [6] and the Cochrane review of 2006 [7]. However, as the Cochrane review points out, there has never been a full randomised controlled trial of supportive care plus or minus WBRT and this information is of utmost importance, particularly in the non-small cell lung cancer group.…”

Section: Survival Of Patients With Non-small Cell Lung Cancer and Bramentioning

confidence: 98%

Survival of Patients with Non-small Cell Lung Cancer and Brain Metastases

Barton

Wilson²,

Faivre-Finn

et al. 2011

Clinical Oncology

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“…This has been the accepted standard treatment for palliation of brain metastases for the past 3 decades. 10 However, the resulting toxicity is signifi cant and no randomised evidence of either symptomatic or survival benefi t exists in the CT era. 1 Common toxicities of WBRT include fatigue, alopecia, scalp erythema and impaired higher cognitive function.…”

Section: 9mentioning

confidence: 99%