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A Pilot Study of Trans-Arterial Injection of 166Holmium-Chitosan Complex for Treatment of Small Hepatocellular Carcinoma

 Byoung Chul Cho  ;  Eun Hee Kim  ;  Joo Hyuk Sohn  ;  Nae Choon Yoo  ;  Jong Tae Lee  ;  Jong Doo Lee  ;  Joong Bae Ahn  ;  Hyun Cheol Chung  ;  Jae Kyung Roh  ;  Joo Hang Kim  ;  Hye Jin Choi 
 YONSEI MEDICAL JOURNAL, Vol.46(6) : 799-805, 2005 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/radiotherapy* ; Chitosan/administration & dosage ; Chitosan/therapeutic use* ; Female ; Humans ; Injections, Intra-Arterial ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Liver Neoplasms/radiotherapy* ; Male ; Middle Aged ; Pilot Projects ; Radiopharmaceuticals/administration & dosage ; Radiopharmaceuticals/therapeutic use* ; Tomography, X-Ray Computed ; alpha-Fetoproteins/metabolism
Hepatocellular carcinoma ; 166Holmium-chitosan complex ; trans-arterial ; internal radiation therapy
Percutaneous approaches, such as percutaneous ethanol injection and radiofrequency ablation, have been most widely used for hepatocellular carcinoma patients who were not eligible for surgery. New technologies to improve the efficacy are currently needed. 166Holmium is a neutron activated radionuclide, and has several beneficial radiophysical characteristics for internal radiation therapy. 166Holmium-Chitosan complex, in which chitosan is chelated with 166Holmium, was developed as a radiopharmaceutical for cancer therapy. We have conducted a pilot study to evaluate the clinical efficacy of transarterial administration of 166Holmium-Chitosan complex in patients with a single and small (< 3 cm) hepatocellular carcinoma. 166Holmium-Chitosan complex, at a dose of 20 mCi per cm of tumor mass-diameter, was administered through the artery that directly fed the tumor. Twelve patients were treated with a median follow-up duration of 26 (range: 12-61) months. The tumor diameter ranged between 1.5 and 2.5 cm. Ten patients (83%) had complete response and two (17%) had partial response. The median complete response duration was not reached. The median AFP level declined from 83.8 to 8.3 ng/mL within 2 months after treatment. No grade III/IV toxicity was observed. Grade I and II toxicities were observed in four patients (2 abdominal pain, 1 fever, and 1 AST/ALT elevation). No toxic death occurred. This preliminary study shows a promising and durable complete response rate with an acceptable safety profile. Further studies with greater accrual of patients are warranted.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Hang(김주항)
Roh, Jae Kyung(노재경)
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Yoo, Nae Choon(유내춘)
Lee, Jong Doo(이종두)
Lee, Jong Tae(이종태)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
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