Radioembolisation with personalised dosimetry: improving outcomes for patients with advanced hepatocellular carcinoma
Mené en France sur 60 patients atteints d'un carcinome hépatocellulaire de stade localement avancé, cet essai multicentrique de phase II compare l'efficacité, du point de vue du taux de réponse objective, et la sécurité de deux approches d'irradiation interne sélective basées sur l'utilisation de microsphères de verre chargées en yttrium-90, l'une comportant une dose personnalisée de rayonnements ionisants, l'autre une dose standard
In The Lancet Gastroenterology & Hepatology, Etienne Garin and colleagues 1
report a randomised, multicentre, phase 2 trial comparing standard dosimetry (120 ± 20 Gy targeted to the perfused lobe) with personalised dosimetry (≥205 Gy targeted to the index tumour) in patients with unresectable, locally advanced hepatocellular carcinoma undergoing selective internal radiation therapy with yttrium-90 ( 90Y)-loaded glass microspheres (TheraSphere, Boston Scientific, Marlborough, MA, USA). The personalised approach delivered higher tumour radiation doses, maintained a benign adverse event profile, and resulted in improved objective response rates and overall survival when compared with standard dosimetry (26·6 months [95% CI 11·7–not reached] in the personalised dosimetry group vs 10·7 months [6·0–16·8] in the standard dosimetry group, p=0·0096). 1
The Lancet Gastroenterology & Hepatology , commentaire, 2019