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Phase II study of transarterial holmium-166-chitosan complex treatment in patients with a single, large hepatocellular carcinoma

 Joo Hyuk Sohn  ;  Hye Jin Choi  ;  Jong Tae Lee  ;  Jong Doo Lee  ;  Joo Hang Kim  ;  Young Myung Moon  ;  Kyungsoo Park  ;  Kyung Bae Park  ;  Eunhee Kim  ;  Nae Choon Yoo 
 ONCOLOGY, Vol.76(1) : 1-9, 2009 
Journal Title
Issue Date
Adult ; Antineoplastic Agents/therapeutic use ; Antineoplastic Agents/toxicity ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/radiotherapy* ; Chitosan/administration & dosage ; Chitosan/therapeutic use* ; Chitosan/toxicity ; Dose-Response Relationship, Drug ; Drug Administration Routes ; Holmium/administration & dosage ; Holmium/therapeutic use* ; Holmium/toxicity ; Humans ; Liver Function Tests ; Models, Theoretical ; Patient Selection ; Radioisotopes/therapeutic use* ; Radioisotopes/toxicity ; Radiotherapy Dosage ; Survival Rate ; Young Adult
Hepatocellular carcinoma ; Holmium-166-chitosan complex ; Internal radiation therapy ; Intraarterial injection
PURPOSE: Holmium-166 ((166)Ho) is a neutron-activated radioactive isotope whose effectiveness in hepatocellular carcinoma (HCC) was first reported in a preclinical study in 1991. Chitosan is a polymer of 2-deoxy-2-amino-D-glucose that readily forms a chelate with heavy metals and converts from a solution under acidic conditions into a gel under neutral or basic conditions. We performed a prospective trial of a transarterial administration of a radiopharmaceutical (166)Ho-chitosan complex in patients with single, large HCC. PATIENTS AND METHODS: The study involved 54 patients who had single HCC (>or=3 cm) without a vascular shunt and were either inoperable or refused surgery. The (166)Ho-chitosan complex was administered at a dose of 20 mCi per cm of tumor diameter (capping at 200 mCi) via the artery that directly fed the tumor. RESULTS: The median tumor size was 5.3 cm (range: 3-13 cm). The response rate was 78% (42/54), and 31 patients had a complete response for a median duration of 27 months. The incidence of grade 3 or 4 leukopenia was 18.6%, anemia 7.4%, thrombocytopenia 27.8%, AST/ALT elevation 26%/24%, and total bilirubin elevation 5.6%. There were two treatment-related deaths (3.7%). Subset analysis revealed a substantial difference between the two groups categorized by tumor size (3-5 vs. >5 cm) with respect to response rate (p = 0.004) and overall survival (p = 0.02). CONCLUSION: We found that transarterial administration of the (166)Ho-chitosan complex was highly effective in the treatment of HCC with acceptable toxicities, especially for patients with tumors of 3-5 cm.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Hang(김주항)
Park, Kyungsoo(박경수) ORCID logo https://orcid.org/0000-0002-6972-1143
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
Yoo, Nae Choon(유내춘)
Lee, Jong Doo(이종두)
Lee, Jong Tae(이종태)
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
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