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Gewählte Publikation:

Schumacher, T; Hofer, S; Eichhorn, K; Wasner, M; Zimmerer, S; Freitag, P; Probst, A; Gratzl, O; Reubi, JC; Maecke, R; Mueller-Brand, J; Merlo, A.
Local injection of the 90Y-labelled peptidic vector DOTATOC to control gliomas of WHO grades II and III: an extended pilot study.
Eur J Nucl Med Mol Imaging. 2002; 29(4):486-493
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Autor/innen der Med Uni Graz:
Zimmerer Martin Stephan Erich
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Abstract:
We have previously presented preliminary observations on targeting somatostatin receptor-positive malignant gliomas of all grades by local injection of the radiolabelled peptidic vector 90Y-DOTATOC. We now report on our more thorough clinical experience with this novel compound, focussing on low-grade and anaplastic gliomas. Small peptidic vectors have the potential to target invisible infiltrative disease within normal surrounding brain tissue, thereby opening a window of opportunity for early intervention. Five progressive gliomas of WHO grades II and III and five extensively debulked low-grade gliomas were treated with varying fractions of 90Y-DOTATOC. The vectors were locally injected into the resection cavity or into solid tumour. The activity per single injection ranged from 555 to 1,875 MBq, and the cumulative activity from 555 to 7,030 MBq, according to tumour volumes and eloquence of the affected brain area, yielding dose estimates from 76+/-15 to 312+/-62 Gy. Response was assessed by the clinical status, by steroid dependence and, every 4-6 months, by magnetic resonance imaging and fluorine-18 fluorodeoxyglucose positron emission tomography. In the five progressive gliomas, lasting responses were obtained for at least 13-45 months without the need for steroids. Radiopeptide brachytherapy had been the only modality applied to counter tumour progression. Interestingly, we observed the slow transformation of a solid, primarily inoperable anaplastic astrocytoma into a resectable multi-cystic lesion 2 years after radiopeptide brachytherapy. Based on these observations, we also assessed the feasibility of local radiotherapy following extensive debulking, which was well tolerated. Targeted beta-particle irradiation based on diffusible small peptidic vectors appears to be a promising modality for the treatment of malignant gliomas.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Brachytherapy - methods
Brain Neoplasms - classification Brain Neoplasms - radionuclide imaging Brain Neoplasms - radiotherapy Brain Neoplasms - surgery
Dose-Response Relationship, Radiation -
Feasibility Studies -
Female -
Fluorodeoxyglucose F18 - diagnostic use
Follow-Up Studies -
Glioma - classification Glioma - radionuclide imaging Glioma - radiotherapy Glioma - surgery
Humans -
Injections, Intralesional -
Magnetic Resonance Imaging -
Male -
Middle Aged -
Octreotide - administration & dosage Octreotide - analogs & derivatives
Pilot Projects -
Radiopharmaceuticals - administration & dosage Radiopharmaceuticals - diagnostic use
Radiotherapy Dosage -
Radiotherapy, Adjuvant -
Receptors, Somatostatin - analysis
Sensitivity and Specificity -
Treatment Outcome -
World Health Organization -
Yttrium Radioisotopes - administration & dosage

Find related publications in this database (Keywords)
gliomas
peptidic receptor targeting
yttrium-90 labelled octreotide
local injection
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