%0 Journal Article %T High impact of macroaggregated albumin-based tumour dose on response and overall survival in hepatocellular carcinoma patients treated with (90) Y-loaded glass microsphere radioembolization %+ Foie, métabolismes et cancer %+ CRLCC Eugène Marquis (CRLCC) %+ Laboratoire Traitement du Signal et de l'Image (LTSI) %+ Service de médecine nucléaire [Rennes] %+ Université de Rennes (UR) %+ Département de Radiologie [CHU de Rennes] %+ Département d'oncologie médicale [Rennes] %A Garin, Etienne %A Rolland, Yan %A Pracht, Marc %A Le Sourd, Samuel %A Laffont, Sophie %A Mesbah, Habiba %A Haumont, Laure-Anne %A Lenoir, Laurence %A Rohou, Tanguy %A Brun, Vanessa %A Edeline, Julien %Z Labex IRON %< avec comité de lecture %@ 1478-3223 %J Liver International %I Wiley-Blackwell %V 37 %N 1 %P 101-110 %8 2017-01 %D 2017 %R 10.1111/liv.13220 %M 27514012 %K predictive dosimetry %K overall survival %K response %K radioembolization %Z Life Sciences [q-bio]/Cancer %Z Life Sciences [q-bio]/Human health and pathology/Hépatology and GastroenterologyJournal articles %X BACKGROUND & AIMS: Efficacy of radioembolization is derived from radioinduced damage, whereas tumour dosimetry is not considered as yet in prospective clinical trials. OBJECTIVES: This study evaluates the impact of tumour dose (TD), based on (99m) Tc macroaggregated albumin (MAA) quantification, on response and overall survival (OS). MATERIALS AND METHODS: We consecutively included 85 patients with hepatocellular carcinoma treated with (90) Y-loaded glass microspheres. TD was calculated using a quantitative analysis of the MAA SPECT/CT. Responses were assessed after 3 months using the European Association for the Study of the Liver criteria. OS was assessed using Kaplan-Meier tests. RESULTS: Response rate was 80.3% on lesion-based analysis (n=132), and 77.5% on patient-based analysis. The response rate was only 9.1% for patients with TD <205 Gy against 89.7% for those with TD ≥205 Gy (P<10(-7) ). Non-portal vein thrombosis (PVT) patients exhibited a median OS of 11.75 m (95% CI: 3-30.7 m) for TD <205 Gy, and 25 m (95% CI: 15-34.7 m) for TD ≥205 Gy (P=.0391). PVT patients exhibited a 4.35 m median OS (95% CI: 2-8 m) for TD<205 Gy, and 15.7 m (95% CI: 9.5-25.5 m) for TD ≥205 Gy, (P=.0004), with HR of 6.99. PVT patients exhibited a median OS of 3.6 m (95% CI: 2-8 m) when PVT MAA targeting was poor or with TD <205 Gy (poor candidate), vs 17.5 m (95% CI: 11-26.5 m) for the others identified as good candidates (P<.0001), with HR of 12.85. CONCLUSION: This study confirms the highly predictive value of MAA-based TD evaluation for response and OS. TD evaluation and PVT MAA targeting should be further evaluated in ongoing trials, whereas personalized dosimetry should be implemented in new trial designs. %G English %2 https://univ-rennes.hal.science/hal-01447063/document %2 https://univ-rennes.hal.science/hal-01447063/file/Garin_High%20impact%20of%20macroaggregated.pdf %L hal-01447063 %U https://univ-rennes.hal.science/hal-01447063 %~ INSERM %~ UNIV-RENNES1 %~ LTSI %~ IFR140 %~ FNCLCC %~ MARQUIS %~ HL %~ U991 %~ U991-E4 %~ METRIQ %~ STATS-UR1 %~ NUMECAN %~ NUMECAN-TGTC %~ UR1-UFR-SVE %~ UR1-HAL %~ UR1-MATH-STIC %~ UR1-SDV %~ TEST-UNIV-RENNES %~ TEST-UR-CSS %~ UNIV-RENNES %~ NUMECAN-METHER %~ UR1-MATH-NUM %~ UR1-BIO-SA