Selective hepatic arterial infusion of In-111-DTPA-Phe1-octreotide in neuroendocrine liver metastases.
OBJECTIVE
The aim of this study is to evaluate the effectiveness of (111)In-DTPA-Phe(1)-octreotide infusions after selective catheterization of the hepatic artery in inoperable metastasised liver, sst(2) receptor-positive neuroendocrine tumours due to the effect of (111)In Auger electron emission, minimising in parallel the toxicity of non-target tissue.


METHODS
The average dose per session administered monthly to each patient (17 cases in total) was 6.3+/-2.3 GBq. Repetitions did not exceed 12-fold, except in one case (15 sessions). Response assessment was classified according to the Response Evaluating Criteria in Solid Tumours. CT/MRI scans were performed as baseline before, during and after the end of treatment, and monthly ultrasound images for follow-up measurements. Toxicity (World Health Organization criteria) was measured using blood and urine tests of renal, hepatic and bone marrow function.


RESULTS
Complete response was achieved in one (5.9%) patient and partial in eight (47.0%), and disease stabilization in 3 (17.7%) patients; five (29.4%) did not respond. A 32-month median survival time was estimated in 12 (70.5%). Nine of these 12 surviving had a mean target diameter shrinkage from 144+/-81 to 60+/-59 mm. Grade 1 erythro-, leuko- and thrombo-cytopenia occurred in three (17.6%) cases.


CONCLUSIONS
In unresectable metastatic liver lesions positive for somatostatin receptors repeated, transhepatic high doses of (111)In-DTPA-Phe(1)-octreotide show an effective therapeutic outcome. Given the locoregional modality character of the administration technique plus the extremely short range of (111)In Auger and internal conversion electrons emission, no nephro-, liver- or myelo-toxicity has so far been observed.
Divisions of Nuclear Medicine, Radiology I Department, Aretaieion University Hospital, Athens Medical School, Athens, Greece. nucleard@aretaieio.uoa.gr
Georgios S
GS
Limouris
Achilles
A
Chatziioannou
Dimitrios
D
Kontogeorgakos
Dimitrios
D
Mourikis
Maria
M
Lyra
Panagiotis
P
Dimitriou
Anastasia
A
Stavraka
Athanassios
A
Gouliamos
Lambros
L
Vlahos
D000328:Adult; D000368:Aged; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary*; D011877:Radionuclide Imaging; D016896:Treatment Outcome