P. Riva et al., Role of nuclear medicine in the treatment of malignant gliomas: the locoregional radioimmunotherapy approach, EUR J NUCL, 27(5), 2000, pp. 601-609
Citations number
75
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
The high-grade malignant gliomas (anaplastic astrocytomas and glioblastoma)
have a very bad prognosis since the available methods of treatment (surger
y, radiotherapy and chemotherapy) are unable to control the progression of
the disease for long. The use of specific monoclonal antibodies labelled wi
th a suitable isotope (iodine-131 or yttrium-90) represents an effective ap
proach to hamper tumour regrowth. Some authors have injected the antibodies
intravenously, or have tried to increase the tumour/background ratio with
the avidin/ biotin system. In many cases the labelled monoclonal antibodies
were injected directly into the tumoral bed after the operation. The autho
rs' experiences concern a quite large locoregional radioimmunotherapy study
which was performed by using antitenascin antibodies labelled initially wi
th I-131 and more recently with Y-90. The clinical results demonstrate the
ability of this technique to control, for a long time, the growth of these
tumours. The glioblastoma median survival was prolonged to 25 months (I-131
group) or 31 months (Y-90 group). The response rate (which comprises PR, C
R and NED) was 47.1% (glioblastoma I-131 group) or 40% ( glioblastoma Y-90
group). In many cases a significant tumour shrinking effect was radiologica
lly demonstrated. The use of Y-90 proved more favourable ill bulky lesions,
and reduced the radioprotection problems.