Combined radioimmunotherapy and radiotherapy of liver metastases from colorectal cancer: a feasibility study.
BACKGROUND
A combination of radioimmunotherapy (RIT) and radiotherapy (RT) should allow one to increase the dose of radiation targeting a particular tumour without the concomitant increase of toxic side effects. This might be obtained if the dose limiting side effect of each individual radiation therapy concerned different organs.


METHODS
Six patients with limited liver metastatic disease from colorectal cancer were treated with 6.9 GBq (range 4.7 to 8.4 GBq) 131I-labelled anti-CEA MAb F(ab')2 fragments combined with 20 Gy RT to the liver. Both treatments were given in close association, according to timing schedules evaluated in animals that gave the best results.


RESULTS
Reversible bone marrow and liver toxicity was observed in 6 and 5 patients, respectively. Three patients who first received 20 Gy RT to the liver, showed a significant platelet drop upon completion of RT. Repeat computerized tomography (CT) after 2 months showed a minor response in 1 patient and stable disease in 3 patients.


CONCLUSIONS
The study shows potential ways of combining RIT and RT, suggesting that this combination is feasible for the treatment of liver metastases.
Division of Nuclear Medicine, University Hospital of Geneva, Switzerland. Franz.Buchegger@hcuge.ch
F
F
Buchegger
A S
AS
Allal
A
A
Roth
J P
JP
Papazyan
Y
Y
Dupertuis
R O
RO
Mirimanoff
M
M
Gillet
A
A
Pelegrin
J P
JP
Mach
D O
DO
Slosman
D000328:Adult; D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000209:etiology; D002272:Carcinoembryonic Antigen / Q000276:immunology*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008107:Liver Diseases / Q000209:etiology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000628:therapy; D008297:Male; D051379:Mice; D008819:Mice, Nude; D008875:Middle Aged; D011292:Premedication; D016499:Radioimmunotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D014018:Tissue Distribution; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D002272:Carcinoembryonic Antigen; D007140:Immunoglobulin Fab Fragments; D007457:Iodine Radioisotopes