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

J Nucl Med. 2024 Aug 1;65(8):1175-1180. doi: 10.2967/jnumed.124.267774.

Abstract

The benefit of multicompartment dosimetry in the radioembolization of neuroendocrine neoplasms is not firmly established. We retrospectively assessed its potential with patient outcome. Methods: 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. Results: The area under the curve for treatment response based on MAD was 0.79 (cutoff, 196.6 Gy; P < 0.0001). For global PFS, grade (grade 2 vs. 1: hazard ratio [HR], 2.51; P = 0.042; grade 3 vs. 1: HR, 62.44; P < 0.001), tumor origin (HR, 6.58; P < 0.001), and MAD (HR, 0.998; P = 0.003) were significant. For overall survival, no prognostic parameters were significant. Conclusion: 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.

Keywords: multicompartment dosimetry; neuroendocrine neoplasm; radioembolization.

MeSH terms

  • 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

Substances

  • Yttrium Radioisotopes
  • Yttrium-90