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A multicenter study was sponsored by the International Atomic Energy Agency (IAEA) to assess the safety and efficacy of transarterial rhenium-188 ((188)Re) HDD lipiodol (radioconjugate to lipiodol using an HDD kit) in the treatment of unresectable hepatocellular carcinoma. During 5 years, 185 patients received at least 1 treatment of radioconjugate, and 51 were retreated. The level of radioconjugate administered was based on radiation-absorbed dose to critical normal organs, calculated after a "scout" dose of radioconjugate. The total injected activity, including the scout dose during the first treatment, ranged from 21 to 364 mCi (mean, 108 mCi/4 GBq). Immediate and late side-effects were minimal. Tumor size could be evaluated in 88 patients. Among these patients, the objective response rate was 25%; stable disease was observed in 53% and tumor progression in 22%. With a median follow-up of 455 days, the estimated 12- and 24-month overall survival was 46% and 23%. This multicenter study shows that (188)Re lipiodol is a safe and cost-effective method to treat primary hepatocellular carcinoma via the transarterial route and requires further evaluation by treatment of greater numbers of patients.

Citation

Patricia Bernal, Jean-Luc Raoul, Janez Stare, Erdenechimeg Sereegotov, Felix X Sundram, Ajay Kumar, Jae-Min Jeong, Pawana Pusuwan, Chaitanya Divgi, Pat Zanzonico, Gaj Vidmar, John Buscombe, Trinh Thi Minh Chau, Maung Maung Saw, Shaoliang Chen, Ruben Ogbac, Maurizio Dondi, Ajit Kumar Padhy. International Atomic Energy Agency-sponsored multination study of intra-arterial rhenium-188-labeled lipiodol in the treatment of inoperable hepatocellular carcinoma: results with special emphasis on prognostic value of dosimetric study. Seminars in nuclear medicine. 2008 Mar;38(2):S40-5

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PMID: 18243842

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