TY - JOUR
T1 - Evaluation of the Safety and Feasibility of Same-Day Holmium-166 -Radioembolization Simulation and Treatment of Hepatic Metastases
AU - van Roekel, Caren
AU - Harlianto, Netanja I
AU - Braat, Arthur J A T
AU - Prince, Jip F
AU - van den Hoven, Andor F
AU - Bruijnen, Rutger C G
AU - Lam, Marnix G E H
AU - Smits, Maarten L J
N1 - Funding Information:
The Department of Radiology and Nuclear Medicine of the University Medical Center Utrecht has received royalties and research support from Quirem Medical. The HEPAR I and II studies were sponsored by a grant from the Dutch Cancer Society and the Technology Foundation STW .
Funding Information:
The Department of Radiology and Nuclear Medicine of the University Medical Center Utrecht has received royalties and research support from Quirem Medical. The HEPAR I and II studies were sponsored by a grant from the Dutch Cancer Society and the Technology Foundation STW. The authors thank Remmert de Roos and Gerard Krijger for preparing the microspheres. The authors also thank Christiaan van Kesteren for his assistance in designing the figures.
Publisher Copyright:
© 2020 SIR
PY - 2020/10
Y1 - 2020/10
N2 - PURPOSE: To evaluate the safety and feasibility of same-day treatment, including the simulation procedure for assessment of intrahepatic and extrahepatic distribution of the microspheres, with holmium-166 (166Ho)-radioembolization.MATERIALS AND METHODS: This was a secondary analysis of patients included in the 4 prospective studies (HEPAR I, HEPAR II, HEPAR PLuS, and SIM) on 166Ho-radioembolization. The technical success rate of the same-day treatment protocol, defined as the number of patients who completed the same-day treatment, was measured. Total in-room time, duration of the scout procedure, time to imaging, and duration of the treatment procedure were recorded. Reasons for discontinuation or adjustment of treatment were identified. Adverse events that occurred during the treatment day were recorded.RESULTS: One hundred five of 120 scheduled patients completed the same-day treatment with 166Ho-radioembolization (success rate, 88%). After the simulation procedure, treatment was cancelled in 15 patients because of extrahepatic deposition (n = 8), suboptimal tumor targeting (n = 1), unanticipated vascular anatomy (n = 5), and dissection (n = 1). In another 14 patients, the treatment plan was adjusted. The median total procedure time (ie, simulation, imaging, and treatment) was 6:39 hours:minutes (range, 3:58-9:17 hours:minutes). Back pain was a major same-day treatment-related complaint (n = 28).CONCLUSION: 166Ho-radioembolization as a same-day treatment procedure is feasible in most selected patients, although treatment was adjusted in 12% of patients and cancelled in 12% of patients. This approach might be beneficial for a select patient population, such as patients needing a radiation segmentectomy.
AB - PURPOSE: To evaluate the safety and feasibility of same-day treatment, including the simulation procedure for assessment of intrahepatic and extrahepatic distribution of the microspheres, with holmium-166 (166Ho)-radioembolization.MATERIALS AND METHODS: This was a secondary analysis of patients included in the 4 prospective studies (HEPAR I, HEPAR II, HEPAR PLuS, and SIM) on 166Ho-radioembolization. The technical success rate of the same-day treatment protocol, defined as the number of patients who completed the same-day treatment, was measured. Total in-room time, duration of the scout procedure, time to imaging, and duration of the treatment procedure were recorded. Reasons for discontinuation or adjustment of treatment were identified. Adverse events that occurred during the treatment day were recorded.RESULTS: One hundred five of 120 scheduled patients completed the same-day treatment with 166Ho-radioembolization (success rate, 88%). After the simulation procedure, treatment was cancelled in 15 patients because of extrahepatic deposition (n = 8), suboptimal tumor targeting (n = 1), unanticipated vascular anatomy (n = 5), and dissection (n = 1). In another 14 patients, the treatment plan was adjusted. The median total procedure time (ie, simulation, imaging, and treatment) was 6:39 hours:minutes (range, 3:58-9:17 hours:minutes). Back pain was a major same-day treatment-related complaint (n = 28).CONCLUSION: 166Ho-radioembolization as a same-day treatment procedure is feasible in most selected patients, although treatment was adjusted in 12% of patients and cancelled in 12% of patients. This approach might be beneficial for a select patient population, such as patients needing a radiation segmentectomy.
UR - http://www.scopus.com/inward/record.url?scp=85089862626&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2020.01.032
DO - 10.1016/j.jvir.2020.01.032
M3 - Article
C2 - 32861571
SN - 1051-0443
VL - 31
SP - 1593
EP - 1599
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 10
ER -