Dose-Response Relationship in Patients with Liver Metastases from Neuroendocrine Neoplasms Undergoing Radioembolization with 90 Y Glass Microspheres

• Published in: Journal of Nuclear Medicine Vol. 65; no. 8; pp. 1175 - 1180
• Main Authors: Watanabe, Masao, Leyser, Stephan, Theysohn, Jens, Schaarschmidt, Benedikt, Ludwig, Johannes, Fendler, Wolfgang P, Moraitis, Alexandros, Lahner, Harald, Mathew, Annie, Herrmann, Ken, Weber, Manuel
• Format: Journal Article
• Language: English
• Published: United States 01.08.2024
• Subjects: Adult; Aged; Aged, 80 and over; Dose-Response Relationship, Radiation; Embolization, Therapeutic; Female; Glass - chemistry; Humans; Liver Neoplasms - radiotherapy; Liver Neoplasms - secondary; Male; Microspheres; Middle Aged; Neuroendocrine Tumors - pathology; Neuroendocrine Tumors - radiotherapy; Retrospective Studies; Treatment Outcome; Yttrium Radioisotopes - therapeutic use; radioembolization; multicompartment dosimetry; neuroendocrine neoplasm
• ISSN: 0161-5505; 1535-5667; 2159-662X
• DOI: 10.2967/jnumed.124.267774

The benefit of multicompartment dosimetry in the radioembolization of neuroendocrine neoplasms is not firmly established. We retrospectively assessed its potential with patient outcome. Forty-three patients were eligible. The association of mean absorbed dose (MAD) for tumors and treatment response was tested per lesion with a receiver operating characteristic curve analysis, and the association of MAD with progression-free survival (PFS) and overall survival was tested per patient using uni- and multivariate Cox regression analyses. The area under the curve for treatment response based on MAD was 0.79 (cutoff, 196.6 Gy; < 0.0001). For global PFS, grade (grade 2 vs. 1: hazard ratio [HR], 2.51; = 0.042; grade 3 vs. 1: HR, 62.44; < 0.001), tumor origin (HR, 6.58; < 0.001), and MAD (HR, 0.998; = 0.003) were significant. For overall survival, no prognostic parameters were significant. In line with prior publications, a MAD of more than 200 Gy seemed to favor treatment response. MAD was also associated with PFS and may be of interest for radioembolization planning for neuroendocrine neoplasm patients.