Relationship of radiation dose to efficacy of radioembolization of liver metastasis from breast cancer Journal Article
| Authors: | Ridouani, F.; Soliman, M. M.; England, R. W.; Hsu, M.; Moskowitz, C. S.; Doustaly, R.; Sofocleous, C. T.; Boas, F. E.; Yarmohammadi, H.; Deipolyi, A. R. |
| Article Title: | Relationship of radiation dose to efficacy of radioembolization of liver metastasis from breast cancer |
| Abstract: | Purpose: To determine the relationship of tumoral and nontumoral radiation dose to response and toxicity after transarterial radioembolization (TARE) of breast cancer liver metastasis. Methods: This retrospective study evaluated all patients with breast cancer liver metastases treated with TARE (2/2011—6/2019). Extent of disease was measured as unilobar or bilobar on baseline PET/CT prior to TARE. Response was assessed for targeted regions with modified PERCIST criteria on first follow-up PET/CT. Tumoral and nontumoral liver dosimetry was evaluated by performing volumetric segmentation on post-TARE Bremsstrahlung SPECT/CT. ≥Grade 3 hepatotoxicity was defined as ≥grade 3 bilirubin/AST/ALT elevation or ascites requiring intervention. Fisher's exact tests, Wilcoxon rank sum tests, and Kaplan-Meier survival analysis were performed. Results: Among 64 women, 60 patients had pre- and post-TARE PET/CT, of whom 46/60 (77 %) achieved objective response (OR). Responders received higher tumoral dose with a median (interquartile range) of 167 (96–217) vs. 54 (45–62) Gy (p < 0.001). ≥Grade 3 hepatotoxicity occurred in 8/64 (12.5 %) and was associated with higher pre-treatment bilirubin levels of 0.9 (0.9–1.1) vs. 0.5 (0.4—0.7) mg/dL (p = 0.013). Median overall survival (OS) was 11 (95 % CI 10–19) months. Bilobar disease (Hazard Ratio [HR]: 2.77, 95 % CI 1.11–6.89, p = 0.028) and elevated pre-TARE AST (HR 1.02, 95 % CI 1.01–1.03, p < 0.001) were independently associated with shorter survival. ≥Grade 3 hepatotoxicity was associated with reduced survival (p < 0.001). OR was associated with longer OS of 17 months, compared with 10 months (p = 0.027). Conclusion: In TARE for breast cancer liver metastasis, higher tumoral radiation dose (>79.5 Gy) was associated with OR, which was associated with longer survival. Pre-existing liver dysfunction was associated with hepatotoxicity, which was associated with decreased survival. © 2021 Elsevier B.V. |
| Keywords: | breast cancer; dosimetry; hepatotoxicity; radioembolization |
| Journal Title: | European Journal of Radiology |
| Volume: | 136 |
| ISSN: | 0720-048X |
| Publisher: | Elsevier B.V |
| Date Published: | 2021-03-01 |
| Start Page: | 109539 |
| Language: | English |
| DOI: | 10.1016/j.ejrad.2021.109539 |
| PROVIDER: | scopus |
| PUBMED: | 33476965 |
| PMCID: | PMC8595023 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 February 2021 -- Source: Scopus |
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169Hsu -
41Deipolyi -
279Moskowitz -
244Sofocleous -
131Yarmohammadi -
77Boas -
38Ridouani -
3Doustaly
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