title: A pilot study of trans-arterial injection of 166Holmium-Chitosan complex for treatment of small hepatocellular carcinoma.
abstract: Percutaneous approaches, such as percutaneous ethanol injection and radiofrequency ablation, have been most widely used for hepatocellular carcinoma patients who were not eligible for surgery. New technologies to improve the efficacy are currently needed. (166)Holmium is a neutron activated radionuclide, and has several beneficial radiophysical characteristics for internal radiation therapy. (166)Holmium-Chitosan complex, in which chitosan is chelated with (166)Holmium, was developed as a radiopharmaceutical for cancer therapy. We have conducted a pilot study to evaluate the clinical efficacy of transarterial administration of (166)Holmium-Chitosan complex in patients with a single and small (< 3 cm) hepatocellular carcinoma. (166)Holmium-Chitosan complex, at a dose of 20 mCi per cm of tumor mass-diameter, was administered through the artery that directly fed the tumor. Twelve patients were treated with a median follow-up duration of 26 (range: 12-61) months. The tumor diameter ranged between 1.5 and 2.5 cm. Ten patients (83%) had complete response and two (17%) had partial response. The median complete response duration was not reached. The median AFP level declined from 83.8 to 8.3 ng/mL within 2 months after treatment. No grade III/IV toxicity was observed. Grade I and II toxicities were observed in four patients (2 abdominal pain, 1 fever, and 1 AST/ALT elevation). No toxic death occurred. This preliminary study shows a promising and durable complete response rate with an acceptable safety profile. Further studies with greater accrual of patients are warranted.
authors.affiliation: Department of Yonsei Cancer Center and Internal Medicine, Yonsei University College of Medicine, 134 Seodaemun-gu, Shinchon-dong, Seoul 120-752, Korea.
authors.forename: Byoung Chul
authors.initials: BC
authors.lastname: Cho
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Kim
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Choi
authors.forename: Joo Hang
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae Kyung
authors.initials: JK
authors.lastname: Roh
authors.forename: Hyun Cheol
authors.initials: HC
authors.lastname: Chung
authors.forename: Joong Bae
authors.initials: JB
authors.lastname: Ahn
authors.forename: Jong Doo
authors.initials: JD
authors.lastname: Lee
authors.forename: Jong Tae
authors.initials: JT
authors.lastname: Lee
authors.forename: Nae Choon
authors.initials: NC
authors.lastname: Yoo
authors.forename: Joo Hyuk
authors.initials: JH
authors.lastname: Sohn
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D048271:Chitosan / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C508237:(166)holmium-chitosan complex; D019275:Radiopharmaceuticals; D000509:alpha-Fetoproteins; D048271:Chitosan