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EJNMMI Research
Published in: EJNMMI Research 1/2012

Open Access 01-12-2012 | Original research

Hemoglobin level significantly impacts the tumor cell survival fraction in humans after internal radiotherapy

Authors: Stephan Walrand, Renaud Lhommel, Pierre Goffette, Marc Van den Eynde, Stanislas Pauwels, FranÇois Jamar

Published in: EJNMMI Research | Issue 1/2012

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Abstract

Background

Anemia is usually not taken into account in internal radiotherapy. We investigated whether the hemoglobin (Hb) level could have an impact on the tumor response, as observed in external beam radiotherapy (EBRT).

Methods

Absorbed doses of 25 hepatic metastatic sites in eight patients who underwent a liver selective internal radiotherapy (SIRT) were computed by a 3D convolution of a dose deposition kernel with the 90Y time-of-flight positron emission tomography (TOF-PET) images acquired following therapy. Early tumor response was assessed by comparing a follow-up FDG TOF-PET scan with a baseline scan. Hb level was measured on the day of the SIRT procedure.

Results

All patients displayed early tumor response increasing with the tumor-absorbed dose. Significant differences between patients were noted, the response slope correlating with the Hb level. After applying a global fit on all metastases using a tumor radiosensitivity modulated by a Hb enhancement factor (HEF) linearly dependent on the Hb level, a strong correlation (R = 0.96) was observed between the early response and the absorbed dose. Hb level had a major impact on tumor response by modulating HEF by a factor 6.

Conclusions

These results prove the significant impact of Hb level on the tumor response and support the study of methods for correcting tumor hypoxia, such as intensively performed in EBRT. The quantitative analysis of the relationship between tumor doses and early response has the power to allow fast screening of such correction methods in limited patient series. Internal radiotherapy could be more efficient if performed earlier in the therapy line, when the disease- and treatment-related anemia remains limited.
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Metadata
Title
Hemoglobin level significantly impacts the tumor cell survival fraction in humans after internal radiotherapy
Authors
Stephan Walrand
Renaud Lhommel
Pierre Goffette
Marc Van den Eynde
Stanislas Pauwels
FranÇois Jamar
Publication date
01-12-2012
Publisher
Springer Berlin Heidelberg
Published in
EJNMMI Research / Issue 1/2012
Electronic ISSN: 2191-219X
DOI
https://doi.org/10.1186/2191-219X-2-20

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