Abstract
Radiation doses to the tumour and non-tumorous liver compartments
from yttrium-90 microspheres in the treatment of hepatic cancer,
as estimated by a partition model, have been verified by correlation
with the actual doses measured with a beta probe at open surgery.
The validity of the doses to the lungs, the tumour and non-tumorous
liver compartment as estimated by the partition model was further
evaluated in clinical settings. On the basis of the observation that
one of three patients who received more than 30 Gy from a single
treatment and one of two patients who received more than 50 Gy from
multiple treatments developed radiation pneumonitis, it was deduced
that an estimated lung dose < 30 Gy from a single treatment and a
cumulative lung dose < 50 Gy from multiple treatments were probably
the tolerance limits of the lungs. Three of five patients who received
lung doses > 30 Gy as estimated by the partition model and were predicted
to develop radiation pneumonitis, did so despite the use of partial
hepatic embolization to reduce the degree of lung shunting. Furthermore,
a higher radiological response rate and prolonged survival were found
in the group of patients who received higher tumour doses, as estimated
by the partition model, than in the group with lower estimated tumour
doses. Thus the radiation doses estimated by the partition model
can be used to predict (a) complication rate, (b) response rate and
(c) duration of survival in the same manner as the actual radiation
doses measured with a beta probe at open surgery. The partition model
has made selective internal radiation therapy using 90Y microspheres
safe and repeatable without laparotomy.
- 99m
- adult;
- aged;
- aggregated
- albumin,
- brachytherapy;
- carcinoma,
- diagnostic
- dosage
- dosage;
- dose-response
- effects/radionuclide
- effects;
- epidemiology/etiology;
- erapy
- factors;
- female;
- hepatocellular,
- humans;
- imaging;
- liver
- liver,
- lung,
- male;
- microspheres;
- middle
- models,
- mortality/radiotherapy;
- neoplasms,
- pneumonitis,
- radiation
- radiation;
- radioisotopes,
- rate;
- relationship,
- risk
- survival
- tc
- technetium
- theoretical;
- therapeutic
- use;
- yttrium
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