Locoregional Treatment of Glioblastoma With Targeted α Therapy: [ 213 Bi]Bi-DOTA-Substance P Versus [ 225 Ac]Ac-DOTA-Substance P-Analysis of Influence Parameters.

IF 9.6 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Nuclear Medicine Pub Date : 2023-05-01 Epub Date: 2023-03-01 DOI:10.1097/RLU.0000000000004608

Leszek Królicki, Jolanta Kunikowska, Frank Bruchertseifer, Radosław Kuliński, Dariusz Pawlak, Henryk Koziara, Rafał Rola, Alfred Morgenstern, Adrian Merlo

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引用次数: 0

Abstract

Background: Glioblastoma (GB) is the most malignant primary brain tumor. Therefore, introduction of new treatment options is critically important. The aim of this study was to assess local treatment with α emitters [ 213 Bi]Bi-DOTA-substance P (SP) and [ 225 Ac]Ac-DOTA-SP.

Methods: Treatment was performed as salvage therapy in patients with recurrent primary and secondary GB. [ 213 Bi]Bi-DOTA-SP with injected activity 1.85 GBq per cycle was used in 20 primary (48.2 ± 11.8 years old) and in 9 secondary (38.8 ± 10.8 years old) GB patients and [ 225 Ac]Ac-DOTA-SP in 15 primary (45.1 ± 9.9 years old) and in 6 secondary (37.8 ± 6.4 years old) GB patients with a dose escalation scheme (10, 20, and 30 MBq).

Results: Local treatment with [ 213 Bi]Bi-DOTA-SP and [ 225 Ac]Ac-DOTA-SP was well tolerated with only few adverse effects. There was no statistically significant difference between [ 213 Bi]Bi-DOTA-SP and [ 225 Ac]Ac-DOTA-SP groups in survival parameters. For primary GB, survival parameters of patients treated with [ 213 Bi]Bi-DOTA-SP and [ 225 Ac]Ac-DOTA-SP were as follows(in months): progression-free survival time, 2.7 versus 2.4; OS-d (overall survival from time of diagnosis to death from any cause), 23.6 versus 21.0; OS-t (overall survival from the start of treatment to death from any cause), 7.5 versus 5.0; and OS-r (overall survival from recurrence in primary tumors to death from any cause), 10.9 versus 12.0. Survival parameters of secondary GB patients treated with [ 213 Bi]Bi-DOTA-SP and [ 225 Ac]Ac-DOTA-SP were as follows (in months): progression-free survival time, 5.8 versus 2.4; OS-d, 52.3 versus 65.0; OS-t, 16.4 versus 16.0; and OS-c (overall survival from conversion into secondary GB multiforme to death from any cause), 18.4 versus 36.0.

Conclusions: The similarity results of 213 Bi or 225 Ac may suggest that the local treatment of brain tumors can be greatly simplified. The experience to date shows that local radioisotope treatment of brain tumors requires further dosimetry studies, taking into account the complexity of biological processes.

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靶向α治疗胶质母细胞瘤的局部治疗：[213Bi]Bi-DOTA物质P与[225Ac]Ac-DOTA物P影响参数分析。

背景：胶质母细胞瘤是最恶性的原发性脑肿瘤。因此，引入新的治疗方案至关重要。本研究的目的是评估α发射体[213Bi]Bi-DOTA物质P（SP）和[225Ac]Ac-DOTA-SP的局部治疗。方法：对复发性原发性和继发性GB患者进行挽救性治疗。[213 Bi]Bi-DOTA SP在20名原发性（48.2±11.8岁）和9名继发性（38.8±10.8岁）GB患者中使用，每个周期注射活性为1.85 GBq，在15名原发（45.1±9.9岁）或6名继发（37.8±6.4岁）GB病人中使用[225 Ac]Ac-DOTA SP-剂量递增方案（10、20和30 MBq）Ac DOTA SP耐受性良好，仅有少量不良反应。[213Bi]Bi-DOTA SP组和[225Ac]Ac-DOTA SP组在生存参数方面没有统计学上的显著差异。对于原发性GB，接受[213Bi]Bi-DOTA SP和[225Ac]Ac-DOTA治疗的患者的生存参数如下（以月为单位）：无进展生存时间为2.7比2.4；OS-d（从诊断到任何原因死亡的总生存率），23.6对21.0；OS-t（从治疗开始到任何原因死亡的总生存率），7.5对5.0；OS-r（从原发性肿瘤复发到任何原因死亡的总生存率）分别为10.9和12.0。接受[213Bi]Bi-DOTA SP和[225Ac]Ac-DOTA治疗的继发性GB患者的生存参数如下（以月为单位）：无进展生存时间为5.8比2.4；OS-d，52.3对65.0；OS-t，16.4对16.0；和OS-c（从转化为继发性多形性GB到任何原因死亡的总生存率），18.4对36.0。结论：213 Bi或225 Ac的相似性结果可能表明，脑肿瘤的局部治疗可以大大简化。迄今为止的经验表明，脑肿瘤的局部放射性同位素治疗需要进一步的剂量测定研究，同时考虑到生物过程的复杂性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Nuclear Medicine 医学-核医学

CiteScore

2.90

自引率

31.10%

发文量

1113

审稿时长

2 months

期刊介绍： Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty. Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.