study of the treatment of patients with recurrent malignant gliomas with
intratumoral yttrium-90 radioimmunoconjugates
Hopkins K, Chandler C, Bullimore J, Sandeman D, Coakham H, Kemshead JT
Imperial Cancer Research Fund, Frenchay Hospital, Bristol, UK.
A pilot study of the treatment of patients with relapsed malignant gliomas with
direct intratumoral injections of yttrium-90 (90Y) radioimmunoconjugates has
Patients were recruited following maximal tumour resection, and
received 1-3 injections of 90Y conjugated to a monoclonal antibody designated
ERIC-1, which binds the neural cell-adhesion molecule.
Data were collected to
establish clinical toxicity, pharmacokinetics and radiation doses to the cavity
wall and critical body organs.
Twenty-three injections were completed in 15
patients, with a mean injected activity of 675 MBq (range 399-921).
toxicity manifested as cerebral oedema and was readily controlled with
Delayed myelosuppression was observed but no intervention was
Pharmacokinetic analysis confirmed prolonged retention of isotope in
the cavity with correspondingly low activity in the bloodstream.
These data were
translated into estimates of absorbed radiation dose using the Medical Internal
Radiation Dosimetry (MIRD) scheme.
Mean doses, and dose rates, to the wall of
the cavity, i.e. 'tumour,' were very high in comparison to normal tissue doses,
with a further advantage if targeting was achieved.
PMID: 7597210 [PubMed - indexed for MEDLINE]