RT Journal Article
SR Electronic
T1 Transarterial Radioembolization in the TACOME Trial: Dosimetric Analysis and Clinical Features in Predicting Response and Overall Survival
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.125.269519
DO 10.2967/jnumed.125.269519
A1 Soydal, Cigdem
A1 Araz, Mine
A1 Demir, Burak
A1 Ones, Tunc
A1 Sonmezoglu, Kerim
A1 Selcuk, Nalan Alan
A1 Balli, Tugsan
A1 Isık, Emine Goknur
A1 Salancı, Bilge Volkan
A1 Derebek, Erkan
A1 Kesim, Selin
A1 Sahin, Onur Erdem
A1 Piskin, Ferhat Can
A1 Celebioglu, Emre Can
A1 Bilgic, Mehmet Sadik
A1 Kucuk, Nuriye Ozlem
YR 2025
UL http://jnm.snmjournals.org/content/early/2025/05/22/jnumed.125.269519.abstract
AB In this multicenter retrospective study, we aimed to analyze the dose–response and survival relationships and estimate the tumor absorbed radiation dose required to achieve response in colorectal cancer liver metastases treated with 90Y glass microspheres. Methods: Patients with metastatic colorectal cancer treated with 90Y glass microspheres were included in this retrospective study. Mean perfused volume, mean estimated perfused volume absorbed dose, mean estimated tumor absorbed dose (ETAD), mean estimated perfused normal liver absorbed dose, and mean estimated whole liver absorbed dose were calculated using [99mTc]-macroaggregated albumin SPECT images. Treatment to response was evaluated by [18F]-FDG PET images. Results: In total, 176 patients (112 men and 64 women) were included in the analysis. A strong correlation was found between mean ETAD and response to treatment (P = 0.001). The cutoff values to predict a response were calculated as 109 Gy (sensitivity, 68%; specificity, 73%; area under the curve, 0.728; P = 0.001) for mean estimated perfused volume absorbed dose and 152 Gy (sensitivity, 93%; specificity, 89%; area under the curve, 0.945; P = 0.001) for mean ETAD. The median overall survival (OS) of patients with a mean ETAD higher than 152 Gy was significantly longer than that of the remaining patients, at 18.1 mo (95% CI, 15.7–20.4 mo) versus 12.8 mo (95% CI, 10.6–15.0 mo; P = 0.030). Further analysis using maximally selected rank statistics to better predict OS showed that patients with a minimum mean ETAD of 203 Gy had OS 6.4 mo longer than the OS of those with a lower mean ETAD (P = 0.022). Conclusion: A mean radiation dose to the tumor of at least 152 Gy may predict a metabolic response. Although a threshold of 152 Gy predicted longer OS, a mean ETAD of 203 Gy, when achievable, predicted even longer OS than found for those with a mean ETAD of less than 203 Gy.