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A Pilot Study of Stereotactic Body Radiotherapy and 177Lu-PSMA-617 for Oligometastatic Hormone Sensitive Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e112. [PMID: 37784650 DOI: 10.1016/j.ijrobp.2023.06.891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic body radiotherapy (SBRT) is increasingly used for oligorecurrent prostate cancer (OPC). Despite excellent local control, distant metastasis free survival rates are more modest. We hypothesized SBRT outcomes could be optimized with improved staging imaging and integration of a well-tolerated targeted radiopharmaceutical therapy (RLT) for microscopic disease. We report initial results of a prospective, single-institution pilot (NCT05079698) of a novel, PSMA-based theranostic strategy for OPC. MATERIALS/METHODS Men with castrate sensitive OPC and 1-3 sites of PSMA PET avid disease ("index lesions") and no PSMA non-avid sites were eligible. No androgen deprivation therapy was permitted. Subjects first received 2 cycles of 177Lu-PSMA-617 RLT (7.47±0.14 GBq) spaced 6 weeks apart. In vivo dosimetry was performed during cycle 1. Four weeks post-cycle 2, patients were restaged with 68Ga-PSMA PET for an interim (post-RLT) response assessment. Index lesions were then consolidated with SBRT (9 Gy x 3) irrespective of post-RLT PET response. The primary outcome was feasibility defined as successful completion of protocol-mandated therapy without intercurrent distant failure on post-RLT PET. RESULTS Six men were treated with nine total index lesions (5 nodal, 3 osseous, 1 visceral). The study met its primary endpoint; all completed required interventions and no distant progression was seen on interim PSMA PET. Treatment was well tolerated; no grade 3+ toxicities, 2/6 had grade 2 toxicities (transient anemia and hyperbilirubinemia) and 5/6 had grade 1 toxicities. Median baseline lesion-level PSMA SUVmax was 16.8±8.7. Median interim SUVmax was 6.2±2.5 and declined for all but one lesion post-RLT (median -65%). Median SUVmax at 3-mos post-SBRT was 3.3±2.5 and decreased for all evaluable lesions (median -80%). Median baseline PSA was 2.01 ng/mL (range: 0.72-4.56) which declined in 5/6 post-RLT. The 6th patient experienced biochemical rise with interim PET showing only greater avidity in the known index lesion and SBRT was completed per protocol. All 4 evaluable patients with at least one post-SBRT follow-up have improved PSA at last visit (range 5.5-12 mos from cycle 1), and 2/4 have undetectable PSA. Composite dosimetry, correlatives and quality of life studies are forthcoming. CONCLUSION Our pilot study demonstrates the feasibility of a novel PSMA anchored theranostic strategy combining SBRT with targeted RLT for OPC. Preliminary data suggests promising outcomes, including the possibility of achieving an undetectable biochemical disease state without hormone therapy.
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Characterizing neck and spinal response in booster seated reclined children in frontal impacts. TRAFFIC INJURY PREVENTION 2023; 24:S32-S40. [PMID: 37267004 DOI: 10.1080/15389588.2023.2188985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Belt-positioning booster seats (BPB) and pre-pretensioner (PPT) belts may be effective in preventing injuries from submarining and head excursion in reclined children. It is unknown if injuries at the neck and spine could still occur. This study's goal is to characterize neck and spine responses in reclined children with and without the BPB and the PPT. METHODS Eleven frontal impact sled tests were performed (56 kph) with the Large Omnidirectional Child (LODC) dummy on a production vehicle seat. A 3-point simulated seat-integrated-belt was used with a load-limiter (∼4.5 kN). Testing was conducted with and without the BPB with the seatback at ∼25°, ∼45° and repeated once. One test was conducted at ∼60° with the BPB. 100 mm of belt-slack was removed to simulate PPT in two 45° BPB tests and the BPB 60° test. The LODC peak thoracic spine accelerations and angular rotations, and peak neck and lumbar force/moment loads were compared between conditions. RESULTS Neck shear forces were the highest in the 60° BPB & PPT (-1.9 kN) and 45° noBPB (-1.3 kN) than all other BPB conditions (-0.5 to -0.8 kN). The highest peak neck moments were found in the 45° noBPB (-40.5 N-m), and in the 60° BPB & PPT (-34.2 N-m) conditions compared to all others (-20.8 to -27.9 N-m.). The 60° BPB and PPT condition demonstrated thoracic forward rotation similar to the 25° noBPB condition (25° noBPB -24.8 to -35.0 deg, 60° BPB&PPT -27.5 to -43.2 deg.). Thoracic spine peak resultant accelerations (T1, T6, T12) were higher in the 25° and 45° noBPB conditions (53 g to 71 g) and in the 60° BPB & PPT (T6: 61.8 g) compared to all other BPB conditions (48.4 g to 53.1 g). The lumbar peak shear forces and moments were the highest in the 45° noBPB (4.9 kN, -296 N-m) and the 60° BPB & PPT condition (1.7 kN, -146 N-m). CONCLUSION These findings show similarities in neck, spine, and lumbar responses between the 60° reclined condition with BPB and PPT and the 25° and 45° conditions without the same countermeasures. This study highlights the need for future restraint developments to protect moderate and severe reclined BPB-seated child occupants.
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Tumor Volume Predicts for Baseline Hypoxia Status in HPV Related Oropharyngeal Carcinomas (OPC) that Underwent Major Radiation De-escalation: The 30 Reduction in Oropharyngeal Cancer Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Intra-Treatment Tumor Apparent Diffusion Coefficient, a Quantitative Imaging Metric, is Associated with Neck Nodal Recurrence in De-Escalated Treatment of HPV-Positive Oropharyngeal Cancer (OPC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract No. 26 Optimizing Y-90 particle density improves outcomes after radioembolization. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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PO-1583: Non-invasive radiomic imaging prediction of tumour hypoxia: biomarker for FLASH irradiation? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01601-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Genetic and micro-environmental factors influencing response to definitive 30Gy chemo-radiotherapy (chemoRT) in HPV Positive Oropharyngeal Cancer (OPC). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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EP-2147 Commissioning of a novel brachytherapy device for diffusive alpha-particle radiation therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32567-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract No. 448 Comparison of electrochemotherapy and radiation for chemosensitization of drug resistant cell lines. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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A pilot study of neuropsychological functions, APOE and amyloid imaging in patients with gliomas. J Neurooncol 2017; 136:613-622. [PMID: 29168082 PMCID: PMC5807139 DOI: 10.1007/s11060-017-2692-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/18/2017] [Indexed: 12/27/2022]
Abstract
Brain tumor patients treated with radiotherapy (RT) often develop cognitive dysfunction, and recent studies suggest that the APOE ε-4 allele may influence cognitive outcome. The ε-4 allele is known to promote beta (β) amyloid deposition in the cortex, and preliminary evidence suggests that RT may be associated with this process. However, it is unknown whether β-amyloid accumulation contributes to treatment neurotoxicity. In this pilot study, we assessed neuropsychological functions and β-amyloid retention using 18F-florbetaben (FBB) PET in a subset of brain tumor patients who participated in our study of APOE polymorphisms and cognitive functions. Twenty glioma patients treated with conformal RT ± chemotherapy participated in the study: 6 were APOE ε-4 carriers and 14 were non-ε-4 carriers. Patients completed a neuropsychological re-evaluation (mean time interval = 5 years, SD = 0.83) and brain MRI and FBB PET scans. Wilcoxon signed-rank test comparisons between prior and current neuropsychological assessments showed a significant decline in attention (Brief Test of Attention, p = 0.018), and a near significant decline in verbal learning (Hopkins Verbal learning Test-Learning, p = 0.07). Comparisons by APOE status showed significant differences over time in attention/working memory (WAIS-III digits forward, p = 0.028 and digits backward, p = 0.032), with a decline among APOE ε-4 carriers. There were no significant differences in any of the FBB PET analyses between APOE ε-4 carriers and non-ε-4 carriers. The findings suggest that glioma patients may experience worsening in attention and executive functions several years after treatment, and that the APOE ε-4 allele may modulate cognitive decline, but independent of increased β-amyloid deposition.
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A Personalized Approach Using Hypoxia Resolution to Guide Curative-Intent Radiation Therapy Dose-Reduction to 30 Gy: A Novel De-escalation Paradigm for HPV-Associated Oropharynx Cancers Treated With Concurrent Chemoradiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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A Pilot Study of Cardiac 13 N-Ammonia PET Imaging to Assess Early Cardiotoxicity Following Multibeam Intensity-Modulated Radiation Therapy for Breast Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Combined FDG and CT Radiomics Features Predict FMISO Uptake in Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Partial Tumor Irradiation in a Murine Model is Sufficient for Tumor Control via Activation of an Antitumor Immune Response. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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TH-AB-206-01: Advances in Radionuclide Therapy - From Radioiodine to Nanoparticles. Med Phys 2016. [DOI: 10.1118/1.4958090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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WE-AB-202-11: Radiobiological Modeling of Tumor Response During Radiotherapy Based On Pre-Treatment Dynamic PET Imaging Data. Med Phys 2016. [DOI: 10.1118/1.4957752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TH-E-202-02: The Use of Hypoxia PET Imaging for Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4958271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Metabolism of Hypoxia-Activated Prodrug Evofosfamide in Hypoxic and Normoxic Conditions and Its Potential to Enhance the Therapeutic Efficacy of Single-Dose Radiation Therapy in Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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SU-E-J-263: Repeatability of SUV and Texture Parameters in Serial PET Studies. Med Phys 2015. [DOI: 10.1118/1.4924349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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WE-AB-204-08: Uncertainties in Kinetic Modeling of Shortened Dynamic 18F-FMISO PET Due to Image Noise. Med Phys 2015. [DOI: 10.1118/1.4925884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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MO-G-17A-07: Improved Image Quality in Brain F-18 FDG PET Using Penalized-Likelihood Image Reconstruction Via a Generalized Preconditioned Alternating Projection Algorithm: The First Patient Results. Med Phys 2014. [DOI: 10.1118/1.4889209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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MO-G-17A-09: Quantitative Autoradiography of Biopsy Specimens Extracted Under PET/CT Guidance. Med Phys 2014. [DOI: 10.1118/1.4889211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TU-A-12A-08: Computing Longitudinal Material Changes in Bone Metastases Using Dual Energy Computed Tomography. Med Phys 2014. [DOI: 10.1118/1.4889254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Preliminary Results of a Prospective Trial of IMRT Dose De-escalation to Gross Nodal Disease in Human Papillomavirus (HPV)-Positive Oropharyngeal Carcinoma (OPC) Based on Assessment of Tumor Hypoxia Using 18F-FMISO PET Imaging. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2013.11.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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SU-D-500-02: Liver Tumor Volume Determination by PET Using Ventilator Suspended Respiration. Med Phys 2013. [DOI: 10.1118/1.4814019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-D-144-01: Implementation of a Clinical Treatment Planning System for Use with a Small Animal Irradiation System. Med Phys 2013. [DOI: 10.1118/1.4814061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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A Pilot Study Of Using Pre- And Early (1 Week) [18f]-misonidazole Positron Emission And Computed Tomography (18F-FMISO PET/CT) Scans As An Early Treatment Response Predictor In A Series Of Head and Neck Cancer (HNC) Patients Undergoing Chemoradiation. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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TU-C-204C-02: Introducton to Cancer Biology. Med Phys 2010. [DOI: 10.1118/1.3469235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TH-C-202-03: The Use of Novel Radiotracers in PET - Potential Applications for Dose Painting. Med Phys 2010. [DOI: 10.1118/1.3469532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-DD-A4-01: The Estimation of the Uncertainty of Activity Concentrations in PET Images. Med Phys 2009. [DOI: 10.1118/1.3181087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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WE-C-303A-03: Pharmacokinetic Analysis of Hypoxia 18-Fluoromisonidazole Dynamic PET Imaging in Head and Neck Cancer. Med Phys 2009. [DOI: 10.1118/1.3182481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Correlation of dynamic contrast enhanced magnetic resonance imaging (DCE MRI) with 18f-fluoromisonidazole positron emission and computed tomography ( 18F-FMISO PET/CT) in assessing tumor hypoxia in a series of head and neck cancer (HNC) patients with nodal metastases. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6083 Background: 18F-FMISO PET/CT is a noninvasive hypoxia imaging modality. Hypoxia can develop within the tumor which typically corresponds to regions with poor blood perfusion. DCE-MRI can yield results on tumor perfusion. The present study compares hypoxic and perfusion status of HNC with nodal metastases using DCE-MRI and 18F-FMISO PET/CT imaging. Methods: 13 HNC (7 base of tongue, 5 tonsil, 1 larynx) patients with nodal metastases underwent both DCE-MRI and 18F-FMISO PET/CT scans prior to chemoradiotherapy. MRI was performed on a 1.5 Tesla GE Excite scanner. DCE-MRI studies were acquired using a fast multi-phase spoiled gradient echo sequence. Antecubital vein catheters delivered a bolus of 0.1 mmol/kg Gd-DTPA at 2 cc/s. For 18F-FMISO PET/CT,∼10.0 mCi of 18F-FMISO was administered IV and images were acquired ∼2 hours later. PET images were reconstructed; CT data were used for attenuation correction. Region of interests (ROIs) were manually drawn by a neuroradiologist. Quantitative DCE-MRI analyses were done using the 2-compartment Tofts model. The analyses calculated the pixel Ktrans(distribution rate constant), ve(extravascular-extra-cellular volume fraction), and kep(redistribution rate constant). 18F-FMISO PET/CT images were analyzed and the uptake by the tumor was scored as: no uptake (score 0); moderate-severe uptake (score 1). Semi-quantitative analysis included standardized uptake value (SUV) measurements. Statistical significance was calculated using a 2-sided Student's t-test, with p < 0.05. Results: A total of 17 nodes were analyzed. For the nodes that showed no hypoxia on PET imaging (n = 7), the mean (±SD) values were: 18F-MISO SUV (1.1 ± 03), Ktrans(0.33 ± 0.18), ve(0.53 ± 0.23), and kep(0.66 ± 0.25). For the nodes that showed moderate to severe 18F-MISO uptake (n = 10) the values were: 18F-FMISO SUV (2.8 ± 08), Ktrans(0.24 ± 0.07), ve(0.61 ± 0.13), and kep (0.43 ± 0.17). A significant lower kep for nodes with 18F-MISO uptake (p = 0.042). Conclusions: Preliminary result supports the hypothesis that the hypoxic nodes are poorly perfused nodes (lower kep values) versus nodes with no hypoxia. No significant financial relationships to disclose.
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TU-D-332-08: Gd-DTPA DCE-MRI Assisted Image-Guided PO2 Measurements in Rodent Tumor Xenografts. Med Phys 2008. [DOI: 10.1118/1.2962599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TU-C-332-07: Accuracy and Reproducibility of Tumor Position During Prolonged and Multi-Modality Animal Imaging Studies. Med Phys 2008. [DOI: 10.1118/1.2962526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-GG-J-109: Inhomogeneities of Intratumoral FDG Uptake in Human Colon Adenocarcinoma HT29 Tumor Model. Med Phys 2008. [DOI: 10.1118/1.2961658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TU-D-332-01: Mapping of Viable Tumor Regions Using Gd-DTPA DCE-MRI. Med Phys 2008. [DOI: 10.1118/1.2962592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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WE-D-AUD C-02: Hypoxia-guided Intensity-Modulated Radiation Therapy for Head and Neck Cancer. Med Phys 2008. [DOI: 10.1118/1.2962743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TU-C-332-09: Effects of Mild Temperature Hyperthermia On Rat HT29 Xenograft Hypoxia Measured with a Dual-Radiolabel Hypoxia Marker. Med Phys 2008. [DOI: 10.1118/1.2962531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TH-C-351-06: Evaluation of a Compartmental Model for Estimating Tumor Hypoxia Via FMISO Dynamic PET Imaging. Med Phys 2008. [DOI: 10.1118/1.2962862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Metastatic neuroblastoma (NB) to the central nervous system (CNS): Improved outcome with combined modality including 131-I-8H9 or 131-I-3F8 radioimmunotherapy (RIT) delivered through the cerebrospinal fluid (CSF). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2022 Background: NB metastatic to the CNS (NB-CNS) is difficult to control. We describe a salvage regimen incorporating intra- Ommaya RIT delivered to the CSF. Methods: 37 patients (pts) with NB-CNS (parenchymal masses and/or leptomeningeal [LM] carcinomatosis) treated at MSKCC from 1988 through 2006 were reviewed. Nine (group #1) of 37 pts developed NB-CNS metastasis (median age 3.8 years) and were treated with a salvage regimen: resection of parenchymal masses, 2160 cGy craniospinal irradiation (CSI), intravenous irinotecan and oral temozolomide, and RIT with 131I-8H9 and or 131I-3F8 targeting tumor associated antigens on phase I/II studies. Immunotherapy (intravenous anti-GD2 monoclonal antibody 3F8 plus subcutaneous GM-CSF) was also given for systemic control. Survival was compared to the other 28 (group #2) pts who developed NB-CNS (median age 4.2 years) treated with combinations of surgery, chemotherapy, and radiation but without CSI + RIT. Results: All 37 pts had high risk disease at initial diagnosis of NB. 9 of 9 group #1 pts had marrow and/or bony involvement; 6 of 9 had MYCN amplification and 5 of 9 had serum LDH >1500 U/ml. All had intensive chemotherapy and radiotherapy prior to CNS relapse. Despite this, the CNS salvage regimen was well-tolerated. Myelosuppression following CSI and chemotherapy was common; 2 pts received stem cell support. All 9 pts in the RIT group are alive and well, disease-free at 3+, 11+, 15+, 18+, 18+, 20+, 22+, 31+, 42+ months since CNS relapse. In contrast, pts in group #2 had a median time to death of 5.5 months, (p<0.0001) for survival by Kaplan-Meier analysis. Conclusion: Similar to CNS metastases in most other solid tumors, conventional therapies have been ineffective for NB-CNS. The addition of RIT using 131I-3F8 or 131I-8H9 is well-tolerated and improves the prognosis for these high risk patients. No significant financial relationships to disclose.
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TH-C-L100J-07: Causes of Inhomogeneities of Intratumoral FDG Uptake. Med Phys 2007. [DOI: 10.1118/1.2761645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-FF-I-109: Image Deconvolution in Autoradiography: A Preliminary Study. Med Phys 2007. [DOI: 10.1118/1.2760486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-FF-J-89: Intratumoral Pattern of FDG Uptake in Human Xenograft Models. Med Phys 2006. [DOI: 10.1118/1.2240865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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SU-FF-I-95: The Use of Deformable Registration Model to Improve Visibility of the Lesion in Gated PET Images. Med Phys 2006. [DOI: 10.1118/1.2240775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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TU-D-330D-01: Molecular Imaging II - Applications. Med Phys 2006. [DOI: 10.1118/1.2241554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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