Experts in HK pioneered new radiotherapy technique for late-stage liver cancer
Experts from the Hong Kong Sanatorium & Hospital (HKSH) recently pioneered a technique of selective internal radiation therapy (SIRT) using Yittrium-90 (90Y) isotopes for the treatment of late-stage liver cancer.
The prospective study, conducted from 2014 to 2017, recruited 62 inoperable liver cancer patients to undergo 90Y glass microsphere radioembolization (90Y-GMRE) after pretreatment dual tracer 11C-acetate and 18F-fluorodeoxyglucose (18F-FDG) for PET/CT scan to direct delivery of 90 Y SIRT. [Eur J Nucl Med Mol Imaging 2018, doi: 10.1007/s00259-018-4064-6]
“The study has opened up a new model of cancer treatment in the approach of ‘theranostics’, which unites therapeutic and diagnostic applications for diagnosis, drug delivery and treatment response monitoring,” said investigator Dr Garrett Chi-Lai Ho, Head of the HKSH Department of Nuclear Medicine and PET.
“Study results showed that the dual tracer PET/CT scan can effectively distinguish the tumour malignancy and dose-response relationships of different malignant tumours to 90Y. Tumours with higher uptake of 11C-acetate are less malignant and have better response to 90Y [72.4 percent]. Tumours with higher uptake of 18F-FDG are more malignant and have lower response to 90Y [25 percent],” said Ho.
“The application of ‘theranostics’ to the treatment of late-stage liver cancer using 90Y SIRT is a big step forward in local advanced medical research, thus achieving more personalized cancer treatment,” he added.
“Data obtained from this study will enable us to derive a new formula for more personalized calculations of 90Y injected activity. Tumours of lesser malignancy can be prescribed a lower target tumour dose and 90Y injected activity to minimize damage to surrounding liver tissues. For highly malignant tumours, increased accuracy of 90Y injected activity can provide better therapeutic effect while limiting the impact on normal liver tissue,” explained investigator Dr William Shing-Kee Cheung, Specialist in Nuclear Medicine from HKSH.
Liver cancer is the third leading cause of cancer mortality in Hong Kong with more than 1,800 new cases and 1,500 deaths reported in 2016. [Hong Kong Cancer Registry, http://www3.ha.org.hk/cancereg/topten.html]