ABSTRACT
This is a descriptive study to assess the safety and efficacy of 188 Rhenium-HDD-Lipiodol conjugate in treating patients with unresectable hepatocellular carcinoma. Eight patients with inoperable hepatocellular carcinoma with liver lesions ranging from 1.8 x 2.0 cm to 12.7 x 70 cm participated in the study. 188 Rhenium-HDD-Lipiodol conjugate was administered to the patients via femoral catheter based on the radioactivity that was eluted from the generator. Corresponding whole body scintigraphic images, which showed significant tracer uptake in the liver lesions, were obtained at 24, 48 and 72 hours after 188 Rhenium-HDD-lipiodol administration. Follow-up CT scans in six patients showed progressive disease in three patients and stable disease in three patients. Two patients had re-treatment due to progression of liver lesions. Follow-up scintigraphy after re-treatment showed decrease in tracer uptake in liver lesions on one patient, while the other showed diffuse tracer uptake. Post-ttherapy symptoms were minimal: mild to moderate epigastric pain in two, nausea and vomiting in one, while the rest are asymptomatic. Karnofsky performance status of patients three months after the therapy ranged from 20-90%. Two of the eight patients are still living at the time this paper was written. Radionuclide therapy aided in the prolongation of life and improvement of its quality for some patients. 188 Rhenium-HDD-Lipiodol radio conjugate provides promising results in treating inoperable hepatocellular carcinoma.
Subject(s)
Humans , Male , Female , Aged , Middle Aged , Adult , Carcinoma, HepatocellularABSTRACT
This paper aims to discuss the sequential use of rituximab and 90Yttrium-ibritumomab tiuxetan, a novel treatment approach in the management of refractory follicular non-Hodgkin's lymphoma. Radioimmunotherapy (RIT), which combines the benefits of targeted radiation therapy and monoclonal antibody, has significantly increased the response rate well in excess of 50%. This is explained by the inherent radiosensitive nature of lymphoma cells. We present a case of a 56-year-old male with refractory follicular lymphoma. The patient was referred for RIT, the first case in the Philippines. The patient was pretreated with two doses of rituximab followed by an intravenous infusion of 90Y-ibritumomab tiuxetan (Zevalin). Hematologic nadir was reached six weeks following administration of the radioimmunotherapy. During this time, the patient developed melena. Hematologic recovery was noted after three weeks. Re-evaluation with computed tomography three months after treatment showed significant reduction in the tumor bulk and resolution of lymphadenopathies. This report underscores the importance and evolving role of radioimmunotherapy in the management of refractory non-Hodgkin's lymphoma.