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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-10222020-173414


Thesis type
Tesi di specializzazione (4 anni)
Author
DEPALO, TOMMASO
URN
etd-10222020-173414
Thesis title
YTTRIUM-90 RADIOEMBOLIZATION AS A PROMISING THERAPEUTIC OPTION IN PATIENTS WITH LIVER METASTASES FROM MEDULLARY THYROID CARCINOMA
Department
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Course of study
MEDICINA NUCLEARE
Supervisors
relatore Prof. Volterrani, Duccio
correlatore Dott. Boni, Giuseppe
Keywords
  • transarterial radioembolization
  • selective internal radiation therapy
  • liver metastases
  • medullary thyroid carcinoma
  • dosimetry
  • yttrium-90 resin microspheres
Graduation session start date
11/11/2020
Availability
None
Summary
Surgical resection is the gold standard in the case of single large metastases fro medullary thyroid carcinoma (MTC) but they are often multiple and disseminated throughout the parenchyma. In this situation, chemoembolization should be considered in patients with disseminated tumor less than 30mm in size involving less than a third of the liver. Otherwise, systemic therapy with tyrosine kinase inhibitors (TKI) is the only remaining therapeutic solution, but it is indicated only in patients with significant tumor burden and documented disease progression.
Patients with initial presentation of liver metastases from MTC who do not meet the indication criteria for surgery or chemoembolization remain untreated until disease progression is not sufficient to justify the use of TKIs. In this setting, transarterial radioembolization (SIRT) is proposed as a promising therapeutic option. SIRT is suitable for the treatment of liver metastases from neuroendocrine tumor and since MTC belongs to this category, the indication for therapy is feasible. The proposal of radioembolization in these patients is to slow down the progression of the disease in order to postpone the use of TKIs.
The primary aim of the present study is to evaluate the efficacy and safety of SIRT in patients with liver metastases from MTC. Other secondary purposes include the assessment of the trend of tumor-specific laboratory markers and the study of dosimetry and radiobiology issues related to SIRT.
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