Table 4.
Key studies on dose-response with 90Y-resin microspheres
| Study | Population | Activity prescription method | Lesion dosimetry assessment | Response assessment | Results |
|---|---|---|---|---|---|
| van den Hoven et al. 2016 [28] | Chemorefractory mCRC (n = 30) | BSA | 90Y-PET 3D voxel-based | Tumour-absorbed dose quantified on 90Y-PET versus TLG on 18F-FDG PET |
50% reduction in TLG at 1 month associated with prolonged OS At least 40–60 Gy required to achieve 50% reduction in TLG |
| Levillain et al. 2018 [29] | Liver-only mCRC progressing after chemotherapy (n = 24) | Partition model | 90Y-PET 3D voxel-based | TLG for each target lesion measured on FDG PET/CT | Cut-offs of 39 Gy and 60 Gy predict non-metabolic response and high-metabolic response, respectively |
| Willowson et al. 2017 [30] | Unresectable mCRC progressing despite chemotherapy (n = 22) | Modified BSA | 90Y-PET 3D voxel-based | Peak standardised uptake value and TLG | Approximately 50 Gy derived as the critical threshold for a significant response (> 50% reduction in TLG) |
| Stigari et al. 2010 [31] | Unresectable HCC (n = 73) | BSA | 90Y-BECT 3D voxel-based | CR and PR according to RECIST | Median dose to achieve CR/PR was 99 Gy |
| Hermann et al. 2020 [32] | Locally advanced unresectable HCC (n = 121) | BSA | 99mTc-MAA SPECT 3D voxel-based | Retrospective assessment of OS in group receiving tumour radiation-absorbed dose < 100 Gy or ≥ 100 Gy |
Median OS 14.1 month in those receiving ≥ 100 Gy Median OS 6.1 months in those receiving < 100 Gy |
| Garin et al. 2019 [52] | HCC with PVT | Multiple | MIRD and 3D voxel-based | Review of studies using treatment response and OS | Predictor of response and OS with a threshold of 100–120 Gy |
| Levillain et al. 2019 [4] | Unresectable and chemorefractory ICC (n = 58) | BSA or partition model | 99mTc-MAA SPECT 3D voxel-based | OS |
Median OS was 5.5 months when BSA used (mean radiation dose to tumour of 38 Gy) Median OS was 14.9 months when partition model was used (mean radiation dose to tumour of 86 Gy) |
| Chansanti et al. 2017 [33] | Unresectable mNET (n = 15) | Partition model | 99mTc-MAA SPECT MIRD | CR and PR according to mRECIST |
Cut-off of ≥ 191.3 Gy for tumour-specific absorbed dose predicted tumour response with 93% specificity < 72.8 Gy predicted non-response with 100% specificity |
BSA, body surface area; CR, complete response; CT, computed tomography; FDG, fluorodeoxyglucose; 99mTc-MAA, technetium-99 m labelled macroaggregated albumin; HCC, hepatocellular carcinoma; ICC, intrahepatic cholangiocarcinoma; mCRC, metastatic colorectal cancer; mNET, metastatic neuroendocrine tumour; OS, overall survival; PET, positron emission tomography; BECT, 90Y bremsstrahlung emission computed tomography; PR, partial response; TLG, total lesion glycolysis