Safety, Efficacy, and Prognostic Factors After Radioembolization of Hepatic Metastases from Breast Cancer: A Large Single-Center Experience in 81 Patients
The present study evaluated safety, efficacy, and prognostic factors for (90)Y-yttrium microsphere radioembolization of unresectable liver metastases from breast cancer. Eighty-one patients were treated with radioembolization. Acute toxicity was monitored through daily physical examination and serum...
Gespeichert in:
| Veröffentlicht in: | Journal of Nuclear Medicine 2016-04, Vol.57 (4), p.517-523 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 523 |
|---|---|
| container_issue | 4 |
| container_start_page | 517 |
| container_title | Journal of Nuclear Medicine |
| container_volume | 57 |
| creator | Fendler, Wolfgang P Lechner, Hanna Todica, Andrei Paprottka, Karolin J Paprottka, Philipp M Jakobs, Tobias F Michl, Marlies Bartenstein, Peter Lehner, Sebastian Haug, Alexander R |
| description | The present study evaluated safety, efficacy, and prognostic factors for (90)Y-yttrium microsphere radioembolization of unresectable liver metastases from breast cancer.
Eighty-one patients were treated with radioembolization. Acute toxicity was monitored through daily physical examination and serum tests until 3 d after radioembolization; late toxicity was evaluated until 12 wk after radioembolization. Overall survival and response according to (18)F-FDG PET (>30% decrease of tracer uptake) and CA15-3 serum level (any decline) were recorded. Pretherapeutic characteristics, including pretreatment history, liver function tests, and PET/CT parameters, were assessed by univariate and subsequent multivariate Cox regression for predicting patient survival.
A toxicity grade of 3 or more based on clinical symptoms, bilirubin, ulcer, pancreatitis, ascites, or radioembolization-induced liver disease occurred in 10% or less of patients. Two patients eventually died from radioembolization-induced liver disease. Sequential lobar treatment and absence of prior angiosuppressive therapy were both associated with a lower rate of serious adverse events. On the basis of PET/CA15-3 criteria, 52/61% of patients responded to treatment. Median overall survival after radioembolization was 35 wk (interquartile range, 41 wk). Pretherapeutic tumor burden of the liver greater than 50% or more (P< 0.001; hazard ratio, 5.67; 95% confidence interval, 2.41-13.34) and a transaminase toxicity grade of 2 or more (P= 0.009; hazard ratio, 2.15; 95% confidence interval, 1.21-3.80) independently predicted short survival.
Radioembolization for breast cancer liver metastases shows encouraging local response rates with low incidence of serious adverse events, especially in those patients with sequential lobar treatment or without prior angiosuppressive therapy. High hepatic tumor burden and liver transaminase levels at baseline indicate poor outcome. |
| doi_str_mv | 10.2967/jnumed.115.165050 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1787979905</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4029435101</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-6a00e341682e0fbb9eec93e4518298d44c02cd04a6f8965369a076bf5f22a3603</originalsourceid><addsrcrecordid>eNpdkdGK1DAUhoMo7uzqA3gjAW-82I4naZOm3o3DrCuMuLh6XdL0ZMjQJmPSguuj-LSmzO6NJJCE_zs_gY-QNwzWvJH1h6OfR-zXjIk1kwIEPCMrJkpRCCnr52QFTLJC5OCCXKZ0BACplHpJLrisK14zWJG_99ri9HBNd9Y6o02-ad_TuxgOPqTJGXqjzRRiohs7YaTfde8Cjl0Y3B89ueBpsPQWT3pBv-KkU96YqI1hpJ8i5jfdam8wfqQbutfxgPTe-cOAxRb90rj7fcLoMCPUeaoYvctdOUqvyAurh4SvH88r8vNm92N7W-y_ff6y3ewLU4GYCqkBsKyYVBzBdl2DaJoSK8EUb1RfVQa46aHS0qpGilI2GmrZWWE516WE8oq8P_eeYvg1Y5ra0SWDw6A9hjm1rFZ1UzcNiIy--w89hjn6_LuF4nmVSmWKnSkTQ0oRbXuKbtTxoWXQLuLas7g2i2vP4vLM28fmuVuip4knU-U_5j6VGw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1782828388</pqid></control><display><type>article</type><title>Safety, Efficacy, and Prognostic Factors After Radioembolization of Hepatic Metastases from Breast Cancer: A Large Single-Center Experience in 81 Patients</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><creator>Fendler, Wolfgang P ; Lechner, Hanna ; Todica, Andrei ; Paprottka, Karolin J ; Paprottka, Philipp M ; Jakobs, Tobias F ; Michl, Marlies ; Bartenstein, Peter ; Lehner, Sebastian ; Haug, Alexander R</creator><creatorcontrib>Fendler, Wolfgang P ; Lechner, Hanna ; Todica, Andrei ; Paprottka, Karolin J ; Paprottka, Philipp M ; Jakobs, Tobias F ; Michl, Marlies ; Bartenstein, Peter ; Lehner, Sebastian ; Haug, Alexander R</creatorcontrib><description>The present study evaluated safety, efficacy, and prognostic factors for (90)Y-yttrium microsphere radioembolization of unresectable liver metastases from breast cancer.
Eighty-one patients were treated with radioembolization. Acute toxicity was monitored through daily physical examination and serum tests until 3 d after radioembolization; late toxicity was evaluated until 12 wk after radioembolization. Overall survival and response according to (18)F-FDG PET (>30% decrease of tracer uptake) and CA15-3 serum level (any decline) were recorded. Pretherapeutic characteristics, including pretreatment history, liver function tests, and PET/CT parameters, were assessed by univariate and subsequent multivariate Cox regression for predicting patient survival.
A toxicity grade of 3 or more based on clinical symptoms, bilirubin, ulcer, pancreatitis, ascites, or radioembolization-induced liver disease occurred in 10% or less of patients. Two patients eventually died from radioembolization-induced liver disease. Sequential lobar treatment and absence of prior angiosuppressive therapy were both associated with a lower rate of serious adverse events. On the basis of PET/CA15-3 criteria, 52/61% of patients responded to treatment. Median overall survival after radioembolization was 35 wk (interquartile range, 41 wk). Pretherapeutic tumor burden of the liver greater than 50% or more (P< 0.001; hazard ratio, 5.67; 95% confidence interval, 2.41-13.34) and a transaminase toxicity grade of 2 or more (P= 0.009; hazard ratio, 2.15; 95% confidence interval, 1.21-3.80) independently predicted short survival.
Radioembolization for breast cancer liver metastases shows encouraging local response rates with low incidence of serious adverse events, especially in those patients with sequential lobar treatment or without prior angiosuppressive therapy. High hepatic tumor burden and liver transaminase levels at baseline indicate poor outcome.</description><identifier>ISSN: 0161-5505</identifier><identifier>EISSN: 1535-5667</identifier><identifier>EISSN: 2159-662X</identifier><identifier>DOI: 10.2967/jnumed.115.165050</identifier><identifier>PMID: 26742710</identifier><identifier>CODEN: JNMEAQ</identifier><language>eng</language><publisher>United States: Society of Nuclear Medicine</publisher><subject>Angiogenesis Inhibitors - therapeutic use ; Breast cancer ; Breast Neoplasms - pathology ; Embolization, Therapeutic - adverse effects ; Embolization, Therapeutic - methods ; Endpoint Determination ; Female ; Fluorodeoxyglucose F18 - metabolism ; Health physics ; Humans ; Liver diseases ; Liver Function Tests ; Liver Neoplasms - diagnostic imaging ; Liver Neoplasms - radiotherapy ; Liver Neoplasms - secondary ; Middle Aged ; Nuclear medicine ; Positron-Emission Tomography ; Prognosis ; Radiation therapy ; Radiopharmaceuticals - metabolism ; Treatment Outcome ; Tumor Burden ; Tumors ; Yttrium Radioisotopes - therapeutic use</subject><ispartof>Journal of Nuclear Medicine, 2016-04, Vol.57 (4), p.517-523</ispartof><rights>2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.</rights><rights>Copyright Society of Nuclear Medicine Apr 1, 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-6a00e341682e0fbb9eec93e4518298d44c02cd04a6f8965369a076bf5f22a3603</citedby><cites>FETCH-LOGICAL-c405t-6a00e341682e0fbb9eec93e4518298d44c02cd04a6f8965369a076bf5f22a3603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26742710$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fendler, Wolfgang P</creatorcontrib><creatorcontrib>Lechner, Hanna</creatorcontrib><creatorcontrib>Todica, Andrei</creatorcontrib><creatorcontrib>Paprottka, Karolin J</creatorcontrib><creatorcontrib>Paprottka, Philipp M</creatorcontrib><creatorcontrib>Jakobs, Tobias F</creatorcontrib><creatorcontrib>Michl, Marlies</creatorcontrib><creatorcontrib>Bartenstein, Peter</creatorcontrib><creatorcontrib>Lehner, Sebastian</creatorcontrib><creatorcontrib>Haug, Alexander R</creatorcontrib><title>Safety, Efficacy, and Prognostic Factors After Radioembolization of Hepatic Metastases from Breast Cancer: A Large Single-Center Experience in 81 Patients</title><title>Journal of Nuclear Medicine</title><addtitle>J Nucl Med</addtitle><description>The present study evaluated safety, efficacy, and prognostic factors for (90)Y-yttrium microsphere radioembolization of unresectable liver metastases from breast cancer.
Eighty-one patients were treated with radioembolization. Acute toxicity was monitored through daily physical examination and serum tests until 3 d after radioembolization; late toxicity was evaluated until 12 wk after radioembolization. Overall survival and response according to (18)F-FDG PET (>30% decrease of tracer uptake) and CA15-3 serum level (any decline) were recorded. Pretherapeutic characteristics, including pretreatment history, liver function tests, and PET/CT parameters, were assessed by univariate and subsequent multivariate Cox regression for predicting patient survival.
A toxicity grade of 3 or more based on clinical symptoms, bilirubin, ulcer, pancreatitis, ascites, or radioembolization-induced liver disease occurred in 10% or less of patients. Two patients eventually died from radioembolization-induced liver disease. Sequential lobar treatment and absence of prior angiosuppressive therapy were both associated with a lower rate of serious adverse events. On the basis of PET/CA15-3 criteria, 52/61% of patients responded to treatment. Median overall survival after radioembolization was 35 wk (interquartile range, 41 wk). Pretherapeutic tumor burden of the liver greater than 50% or more (P< 0.001; hazard ratio, 5.67; 95% confidence interval, 2.41-13.34) and a transaminase toxicity grade of 2 or more (P= 0.009; hazard ratio, 2.15; 95% confidence interval, 1.21-3.80) independently predicted short survival.
Radioembolization for breast cancer liver metastases shows encouraging local response rates with low incidence of serious adverse events, especially in those patients with sequential lobar treatment or without prior angiosuppressive therapy. High hepatic tumor burden and liver transaminase levels at baseline indicate poor outcome.</description><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Embolization, Therapeutic - adverse effects</subject><subject>Embolization, Therapeutic - methods</subject><subject>Endpoint Determination</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18 - metabolism</subject><subject>Health physics</subject><subject>Humans</subject><subject>Liver diseases</subject><subject>Liver Function Tests</subject><subject>Liver Neoplasms - diagnostic imaging</subject><subject>Liver Neoplasms - radiotherapy</subject><subject>Liver Neoplasms - secondary</subject><subject>Middle Aged</subject><subject>Nuclear medicine</subject><subject>Positron-Emission Tomography</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Radiopharmaceuticals - metabolism</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Tumors</subject><subject>Yttrium Radioisotopes - therapeutic use</subject><issn>0161-5505</issn><issn>1535-5667</issn><issn>2159-662X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkdGK1DAUhoMo7uzqA3gjAW-82I4naZOm3o3DrCuMuLh6XdL0ZMjQJmPSguuj-LSmzO6NJJCE_zs_gY-QNwzWvJH1h6OfR-zXjIk1kwIEPCMrJkpRCCnr52QFTLJC5OCCXKZ0BACplHpJLrisK14zWJG_99ri9HBNd9Y6o02-ad_TuxgOPqTJGXqjzRRiohs7YaTfde8Cjl0Y3B89ueBpsPQWT3pBv-KkU96YqI1hpJ8i5jfdam8wfqQbutfxgPTe-cOAxRb90rj7fcLoMCPUeaoYvctdOUqvyAurh4SvH88r8vNm92N7W-y_ff6y3ewLU4GYCqkBsKyYVBzBdl2DaJoSK8EUb1RfVQa46aHS0qpGilI2GmrZWWE516WE8oq8P_eeYvg1Y5ra0SWDw6A9hjm1rFZ1UzcNiIy--w89hjn6_LuF4nmVSmWKnSkTQ0oRbXuKbtTxoWXQLuLas7g2i2vP4vLM28fmuVuip4knU-U_5j6VGw</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Fendler, Wolfgang P</creator><creator>Lechner, Hanna</creator><creator>Todica, Andrei</creator><creator>Paprottka, Karolin J</creator><creator>Paprottka, Philipp M</creator><creator>Jakobs, Tobias F</creator><creator>Michl, Marlies</creator><creator>Bartenstein, Peter</creator><creator>Lehner, Sebastian</creator><creator>Haug, Alexander R</creator><general>Society of Nuclear Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7QO</scope></search><sort><creationdate>201604</creationdate><title>Safety, Efficacy, and Prognostic Factors After Radioembolization of Hepatic Metastases from Breast Cancer: A Large Single-Center Experience in 81 Patients</title><author>Fendler, Wolfgang P ; Lechner, Hanna ; Todica, Andrei ; Paprottka, Karolin J ; Paprottka, Philipp M ; Jakobs, Tobias F ; Michl, Marlies ; Bartenstein, Peter ; Lehner, Sebastian ; Haug, Alexander R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-6a00e341682e0fbb9eec93e4518298d44c02cd04a6f8965369a076bf5f22a3603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Angiogenesis Inhibitors - therapeutic use</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - pathology</topic><topic>Embolization, Therapeutic - adverse effects</topic><topic>Embolization, Therapeutic - methods</topic><topic>Endpoint Determination</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18 - metabolism</topic><topic>Health physics</topic><topic>Humans</topic><topic>Liver diseases</topic><topic>Liver Function Tests</topic><topic>Liver Neoplasms - diagnostic imaging</topic><topic>Liver Neoplasms - radiotherapy</topic><topic>Liver Neoplasms - secondary</topic><topic>Middle Aged</topic><topic>Nuclear medicine</topic><topic>Positron-Emission Tomography</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Radiopharmaceuticals - metabolism</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Tumors</topic><topic>Yttrium Radioisotopes - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fendler, Wolfgang P</creatorcontrib><creatorcontrib>Lechner, Hanna</creatorcontrib><creatorcontrib>Todica, Andrei</creatorcontrib><creatorcontrib>Paprottka, Karolin J</creatorcontrib><creatorcontrib>Paprottka, Philipp M</creatorcontrib><creatorcontrib>Jakobs, Tobias F</creatorcontrib><creatorcontrib>Michl, Marlies</creatorcontrib><creatorcontrib>Bartenstein, Peter</creatorcontrib><creatorcontrib>Lehner, Sebastian</creatorcontrib><creatorcontrib>Haug, Alexander R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Biotechnology Research Abstracts</collection><jtitle>Journal of Nuclear Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fendler, Wolfgang P</au><au>Lechner, Hanna</au><au>Todica, Andrei</au><au>Paprottka, Karolin J</au><au>Paprottka, Philipp M</au><au>Jakobs, Tobias F</au><au>Michl, Marlies</au><au>Bartenstein, Peter</au><au>Lehner, Sebastian</au><au>Haug, Alexander R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety, Efficacy, and Prognostic Factors After Radioembolization of Hepatic Metastases from Breast Cancer: A Large Single-Center Experience in 81 Patients</atitle><jtitle>Journal of Nuclear Medicine</jtitle><addtitle>J Nucl Med</addtitle><date>2016-04</date><risdate>2016</risdate><volume>57</volume><issue>4</issue><spage>517</spage><epage>523</epage><pages>517-523</pages><issn>0161-5505</issn><eissn>1535-5667</eissn><eissn>2159-662X</eissn><coden>JNMEAQ</coden><abstract>The present study evaluated safety, efficacy, and prognostic factors for (90)Y-yttrium microsphere radioembolization of unresectable liver metastases from breast cancer.
Eighty-one patients were treated with radioembolization. Acute toxicity was monitored through daily physical examination and serum tests until 3 d after radioembolization; late toxicity was evaluated until 12 wk after radioembolization. Overall survival and response according to (18)F-FDG PET (>30% decrease of tracer uptake) and CA15-3 serum level (any decline) were recorded. Pretherapeutic characteristics, including pretreatment history, liver function tests, and PET/CT parameters, were assessed by univariate and subsequent multivariate Cox regression for predicting patient survival.
A toxicity grade of 3 or more based on clinical symptoms, bilirubin, ulcer, pancreatitis, ascites, or radioembolization-induced liver disease occurred in 10% or less of patients. Two patients eventually died from radioembolization-induced liver disease. Sequential lobar treatment and absence of prior angiosuppressive therapy were both associated with a lower rate of serious adverse events. On the basis of PET/CA15-3 criteria, 52/61% of patients responded to treatment. Median overall survival after radioembolization was 35 wk (interquartile range, 41 wk). Pretherapeutic tumor burden of the liver greater than 50% or more (P< 0.001; hazard ratio, 5.67; 95% confidence interval, 2.41-13.34) and a transaminase toxicity grade of 2 or more (P= 0.009; hazard ratio, 2.15; 95% confidence interval, 1.21-3.80) independently predicted short survival.
Radioembolization for breast cancer liver metastases shows encouraging local response rates with low incidence of serious adverse events, especially in those patients with sequential lobar treatment or without prior angiosuppressive therapy. High hepatic tumor burden and liver transaminase levels at baseline indicate poor outcome.</abstract><cop>United States</cop><pub>Society of Nuclear Medicine</pub><pmid>26742710</pmid><doi>10.2967/jnumed.115.165050</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0161-5505 |
| ispartof | Journal of Nuclear Medicine, 2016-04, Vol.57 (4), p.517-523 |
| issn | 0161-5505 1535-5667 2159-662X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1787979905 |
| source | MEDLINE; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Angiogenesis Inhibitors - therapeutic use Breast cancer Breast Neoplasms - pathology Embolization, Therapeutic - adverse effects Embolization, Therapeutic - methods Endpoint Determination Female Fluorodeoxyglucose F18 - metabolism Health physics Humans Liver diseases Liver Function Tests Liver Neoplasms - diagnostic imaging Liver Neoplasms - radiotherapy Liver Neoplasms - secondary Middle Aged Nuclear medicine Positron-Emission Tomography Prognosis Radiation therapy Radiopharmaceuticals - metabolism Treatment Outcome Tumor Burden Tumors Yttrium Radioisotopes - therapeutic use |
| title | Safety, Efficacy, and Prognostic Factors After Radioembolization of Hepatic Metastases from Breast Cancer: A Large Single-Center Experience in 81 Patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T11%3A04%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Safety,%20Efficacy,%20and%20Prognostic%20Factors%20After%20Radioembolization%20of%20Hepatic%20Metastases%20from%20Breast%20Cancer:%20A%20Large%20Single-Center%20Experience%20in%2081%20Patients&rft.jtitle=Journal%20of%20Nuclear%20Medicine&rft.au=Fendler,%20Wolfgang%20P&rft.date=2016-04&rft.volume=57&rft.issue=4&rft.spage=517&rft.epage=523&rft.pages=517-523&rft.issn=0161-5505&rft.eissn=1535-5667&rft.coden=JNMEAQ&rft_id=info:doi/10.2967/jnumed.115.165050&rft_dat=%3Cproquest_cross%3E4029435101%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1782828388&rft_id=info:pmid/26742710&rfr_iscdi=true |