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Cardiovasc Intervent Radiol. 2013 Feb;36(1):158-65. doi: 10.1007/s00270-012-0373-5. Epub 2012 Apr 21.

Radioembolization as locoregional therapy of hepatic metastases in uveal melanoma patients.

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1
Department of Ophthalmology, Ludwig-Maximilians University, Mathildenstraße 8, 80336, Munich, Germany. annemarie.klingenstein@med.uni-muenchen.de

Abstract

PURPOSE:

To retrospectively evaluate the overall survival, safety, and efficacy of metastatic uveal melanoma patients after radioembolization as salvage therapy.

MATERIALS AND METHODS:

Thirteen patients were treated with radioembolization of branches of the hepatic artery with resin-based yttrium-90 ((90)Y)-labelled microspheres. Twelve patients underwent a single application, and 1 patient underwent 4 interventions. Dosages from 644 to 2,450 MBq (mean activity 1,780) were applied. Treatment response was evaluated by way of liver magnetic resonance imaging and computed tomography (CT) as well as whole-body fluorodeoxyglucose positron emission tomography (PET)/CT with evaluation of percentage changes in SUV(max) before and at 2-3 months after therapy. Kaplan-Meier analysis was calculated to determine overall survival.

RESULTS:

Partial remission (PR) was observed in 8 (62 %), stable disease (SD) in 2 (15 %), and progressive disease (PD) in 3 (23 %) patients under terms of standard criteria and PR in 3 (23 %), SD in 3 (23 %), and PD in 7 (54 %) patients according to PET criteria. Neither RECIST nor PET criteria showed a significant difference in predicting overall survival (P = 0.12 and 0.11, respectively). Median survival time after radioembolization was 7 months. No acute toxicity with in-hospital morbidity was observed. One patient developed hepatomegaly, and 1 patient developed gastric ulceration. Throughout follow-up, progression of extrahepatic metastases was observed.

CONCLUSION:

Radioembolization may be a promising therapy in uveal melanoma patients with predominant hepatic metastases. At first follow-up, we observed PR or SD in 77 % patients under terms of standard criteria with an acceptable toxicity profile.

PMID:
22526099
DOI:
10.1007/s00270-012-0373-5
[Indexed for MEDLINE]
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