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Targeted alpha-radionuclide therapy of functionally critically located gliomas with 213Bi-DOTA-Thi8,Met(O2)11-substance P: a pilot trial
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Targeted alpha-radionuclide therapy of functionally critically located gliomas with 213Bi-DOTA-Thi8,Met(O2)11-substance P: a pilot trial
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Journal Article
Targeted alpha-radionuclide therapy of functionally critically located gliomas with 213Bi-DOTA-Thi8,Met(O2)11-substance P: a pilot trial
2010
Overview
Purpose
Functionally critically located gliomas represent a challenging subgroup of intrinsic brain neoplasms. Standard therapeutic recommendations often cannot be applied, because radical treatment and preservation of neurological function are contrary goals. The successful targeting of gliomas with locally injected beta radiation-emitting
90
Y-DOTAGA-substance P has been shown previously. However, in critically located tumours, the mean tissue range of 5 mm of
90
Y may seriously damage adjacent brain areas. In contrast, the alpha radiation-emitting radionuclide
213
Bi with a mean tissue range of 81 µm may have a more favourable toxicity profile. Therefore, we evaluated locally injected
213
Bi-DOTA-substance P in patients with critically located gliomas as the primary therapeutic modality.
Methods
In a pilot study, we included five patients with critically located gliomas (WHO grades II–IV). After diagnosis by biopsy,
213
Bi-DOTA-substance P was locally injected, followed by serial SPECT/CT and MR imaging and blood sampling. Besides feasibility and toxicity, the functional outcome was evaluated.
Results
Targeted radiopeptide therapy using
213
Bi-DOTA-substance P was feasible and tolerated without additional neurological deficit. No local or systemic toxicity was observed.
213
Bi-DOTA-substance P showed high retention at the target site. MR imaging was suggestive of radiation-induced necrosis and demarcation of the tumours, which was validated by subsequent resection.
Conclusion
This study provides proof of concept that targeted local radiotherapy using
213
Bi-DOTA-substance P is feasible and may represent an innovative and effective treatment for critically located gliomas. Primarily non-operable gliomas may become resectable with this treatment, thereby possibly improving the prognosis.
Publisher
Springer-Verlag,Springer Nature B.V
Subject
/ Alpha Particles - therapeutic use
/ Brain
/ Heterocyclic Compounds, 1-Ring - administration & dosage
/ Heterocyclic Compounds, 1-Ring - adverse effects
/ Heterocyclic Compounds, 1-Ring - pharmacokinetics
/ Heterocyclic Compounds, 1-Ring - therapeutic use
/ Humans
/ Imaging
/ Medicine
/ Oncology
/ Organometallic Compounds - administration & dosage
/ Organometallic Compounds - adverse effects
/ Organometallic Compounds - pharmacokinetics
/ Organometallic Compounds - therapeutic use
/ Substance P - administration & dosage
/ Substance P - adverse effects
/ Substance P - analogs & derivatives
/ Substance P - pharmacokinetics
/ Substance P - therapeutic use
/ Tumors
