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At least 217 records · Page 12Linked to original sources
PubMed2002

Yttrium-90 microspheres: radiation therapy for unresectable liver cancer.

Hepatocellular carcinoma (HCC) constitutes a difficult health challenge because of its poor prognosis and limited treatment options. Most available therapies are used only for palliation. The use of yttrium-90 microspheres is a new intraarterial therapy consisting of beta-irradiating microspheres measuring 20-30 micro m in diameter that can be delivered directly to the tumors. (90)Y microspheres, which carry the radiation, are selectively taken up by the tumors, thus preserving normal liver. In several studies to date, (90)Y microspheres have proved to have a low toxicity profile and have generally been well tolerated by patients. Other than transient elevation in liver enzyme levels and mild fatigue and fever, no substantial treatment-related toxicities have been observed. Gastrointestinal toxicities occur in a limited number of cases and are preventable with proper knowledge of visceral arterial anatomy. The effect on survival is also promising, with median survival rates of 23 months (95% confidence interval = 14, 44) and 11 months (95% confidence interval = 6, 26) for patients with Okuda stage I and stage II disease, respectively. On the basis of these data, intraarterial delivery of (90)Y microspheres offers a new alternative in the treatment of unresectable HCC.

Carcinoma, Hepatocellular↗
PubMed1996

Effects of an erbium, chromium: yttrium, scandium, gallium, garnet laser on mucocutanous soft tissues.

OBJECTIVES: Lasers are effective tools for soft tissue surgery. The erbium, chromium: yttrium, scandium, gallium, garnet laser is a new system that incorporates an air-water spray. This study evaluates the cutting margins of this laser and compares healing with laser and conventional scalpel and punch biopsy-induced wounds. STUDY DESIGN: New Zealand white rabbits were divided into serial sacrifice groups; the tissues were grossly and microscopically analyzed after laser and convential steel surgical wounding. RESULTS: Wound margins were found to show minimal edge coagulation artifact and were 20 to 40 mm in width. Laser wounds showed minimal to no hemorrhage and re-epithelialization and collagenization were found to occur by day 7 in both laser and conventional groups. CONCLUSIONS: The new laser system is an effective soft tissue surgical device; wound healing is comparable to that associated with surgical steel wounds. The minimal edge artifact observed with this laser system should allow for the procurement of diagnostic biopsy specimens.

Aluminum Silicates↗
PubMed1977

The treatment of acromegaly by Yttrium implantation.

Yttrium implantation is one of the many ways of treating acromegaly. The advantages are the minor nature of the procedure and the fact that pituitary replacement is not as commonly required as after hypophysectomy. Thus in young female patients menstruation may be resumed following treatment and pregnancy has occurred. The procedure is not as free from complications as external irradiation but the response is more satisfactory.

Acromegaly↗
PubMedDate not supplied

A convenient synthesis of bifunctional chelating agents based on diethylenetriaminepentaacetic acid and their coordination chemistry with yttrium(III).

The bifunctional chelating agents N,N,N',N'',N''-pentakis(carboxymethyl)-1- [(4-aminophenyl)methyl]-diethylenetriamine and N,N,N',N'',N''-pentakis(carboxymethyl)-1-[(4-aminophenyl)methyl]-4- methyldiethylenetriamine were prepared in six-step syntheses in overall yields of 38% and 31%, respectively. The use of bromoacetate esters in the synthesis allowed large-scale flash chromatographic purification of reaction products. The synthesis of N,N,N',N'',N''-pentakis(carboxymethyl)-1- [(4-aminophenyl)-methyl]-4-methyldiethylenetriamine resulted in a mixture of two diastereomers. Chelation of yttrium-(III) with these bifunctional chelating agents resulted in 1:1 chelates. In the case of N,N,N',N'',N''-pentakis(carboxymethyl)-1-[4- aminophenyl)methyl]diethylenetriamine, two diastereomers were observed upon chelation, as expected. In the case of N,N,N',N'',N''- pentakis(carboxymethyl)-1-[(4-aminophenyl)-methyl]-4- methyldiethylenetriamine, only three of the four anticipated diastereomers were observed.

Chelating Agents↗
PubMedDate not supplied

Comparison of yttrium and indium complexes of DOTA-BA and DOTA-MBA: models for (90)Y- and (111)In-labeled DOTA-biomolecule conjugates.

Yttrium and indium complexes of 1,4,7,10-tetraaza-4,7,10-tris(carboxymethyl)-1-cyclododecylacetylbenzylamine (DOTA-BA) and 1,4,7,10-tetraaza-4,7,10-tris(carboxymethyl)-1-cyclododecylacetyl-R-(+)-alpha-methylbenzylamine (DOTA-MBA) were prepared in order to study solution structures of (90)Y- and (111)In-labeled DOTA-biomolecule conjugates. (90)Y and (111)In complexes M(L) (M = (90)Y and (111)In; L = DOTA-BA and DOTA-MBA) were prepared from the reaction of MCl(3) with DOTA-BA and DOTA-MBA, respectively, in ammonium acetate buffer. A reverse phase HPLC method revealed that both (90)Y and (111)In complexes show only one radiometric peak in their radio-HPLC chromatograms. It was also found that (111)In(DOTA-BA) and (111)In(DOTA-MBA) are more hydrophilic than their corresponding (90)Y analogues, suggesting different coordination spheres in (111)In and (90)Y complexes of the same DOTA conjugate. Complexes M(L) (M = Y and In; L = DOTA-BA and DOTA-MBA) were prepared and characterized by HPLC, LC-MS, and NMR ((1)H and (13)C) methods. The HPLC concordance experiments for (90)Y(DOTA-MBA)/Y(DOTA-MBA) and (111)In(DOTA-MBA)/In(DOTA-MBA) show that the same complex is prepared at both tracer and macroscopic levels. The NMR data ((1)H and (13)C) clearly demonstrates that Y(DOTA-BA) and Y(DOTA-MBA) exist in solution as one predominant isomer. VT NMR data ((1)H and (13)C) show that In(DOTA-BA) and In(DOTA-MBA) are fluxional at room temperature while Y(DOTA-BA) and Y(DOTA-MBA) become fluxional only at elevated temperatures. The fluxionality of these complexes is due to rapid rotation of acetate/acetamide chelating arms and inversion of ethylenic groups of the macrocyclic ring.

Chelating Agents↗
PubMed2006

Infrared spectroscopic and density functional theory studies on the CO dissociation by scandium and yttrium dimers.

Reactions of laser-ablated scandium and yttrium atoms with dilute carbon monoxide molecules in solid argon have been investigated using matrix-isolation infrared spectroscopy. On the basis of the results of the isotopic substitution, the change of laser power and CO concentration and the comparison with density functional theory (DFT) calculations, the absorption at 1193.4 cm(-1) is assigned to the C-O stretching vibration of the Sc(2)[eta(2)(mu(2)-C,O)] molecule, which has a single bridging CO that is tilted to the side. This CO-activated molecule undergoes ultraviolet-visible photoinduced rearrangement to the CO-dissociated molecule, c-Sc(2)(mu-C)(mu-O). The cyclic c-Sc(2)(mu-C)(mu-O) molecule has a bridging carbon on one side of the Sc(2) unit and a bridging oxygen on the other. The analogous Y(2)[eta(2)(mu(2)-C,O)] molecule has not been observed, but the CO-dissociated c-Y(2)(mu-C)(muO) molecule has been observed in the Y + CO experiments. DFT calculations of the geometry structures, vibrational frequencies, and IR intensities strongly support the assignments. The CO activation mechanism has also been discussed. Our experimental and theoretical results schematically depict an activation process to CO dissociation.

Argon↗
PubMed2001

Selective internal radiation therapy by yttrium-90 microspheres for hepatocellular carcinoma after renal transplantation.

We report a HBsAg-positive patient who developed hepatocellular carcinoma (HCC) 7 years after cadaveric kidney transplantation. The tumor was unresectable because of coexisting cirrhosis. Selective internal radiation (SIR) therapy, a novel therapy with the technique recently perfected, was used. Yttrium-90 microspheres were given via an angiographic catheter under fluoroscopy guidance. Serum alpha-fetal protein (AFP) was normalized within 2 wk. A follow-up abdominal CT scan revealed significant necrosis of the tumor and compensatory hypertrophy of non-diseased liver. The treatment was well tolerated except for transient liver function deterioration. The patient enjoyed 15 months of symptom-free survival before she died of liver failure. Practical aspects and potential applications of SIR therapy in this group of patients are discussed.

Adult↗
PubMed1989

Yttrium-90-EDTMP: a radiotherapeutic agent in the treatment of leukaemias.

Yttrium-90 chelated by the tetraphosphonate EDTMP achieved a high uptake in bone and a rapid clearance from all soft tissues compared with 90Y nitrilotriacetate, citrate and acetate. The biological half-life of 90Y in the bone was greater than 72 h, but the quantity, and therefore dose, could be reduced by 50% using repeated, non-toxic chelation therapy with the calcium salt of DTPA. This treatment should be able to supplement current treatments for leukaemia where the dose of external beam radiation is associated with considerable morbidity.

Animals↗
PubMed2001

Yttrium-90 synoviorthesis for chronic haemophilic synovitis: Madrid experience.

Between 1994 and 1999 we performed 66 Yttrium-90 (90Y) synoviortheses on 44 persons with haemophilia (45 knees, 12 elbows, nine ankles). At the time of injection 23 patients were HIV+ and two had inhibitors. The average age was 21.1 years (range: 9-39). Five mCi of 90Y were injected into the knees, and 3 mCi into the elbows and ankles. The average follow-up was 3.5 years (range: 1-6). Of the 45 knees, there were eight excellent, 10 good, 15 fair and 12 poor results. Of the 12 elbows there were three excellent results, five good, three fair and two poor. Of the nine ankles there were no excellent results, four good, three fair and two poor. The elbows had better results than the knees and ankles. The best results were obtained in the youngest patients, and in those with a moderate degree of synovitis, regardless of their HIV status and the presence of inhibitor. 90Y synoviorthesis should be performed in very young patients, when the amount of synovium is still moderate. Once the degree of synovitis has become severe, the expected results of radioactive synoviorthesis are worse.

Adolescent↗
PubMed2001

Synoviorthesis with radioactive Yttrium in haemophilia: Israel experience.

Radioactive Yttrium-90 (90Y) was injected into 163 joints. Of these patients 115 were persons with haemophilia and they suffered from recurrent haemarthroses. The median age at the time of the initial exposure to 90Y was between 11 and 15 years and the median follow-up period 11 years. Over 80% of the patients with haemophilia reported a decrease in the number of haemarthroses and 15% stopped bleeding altogether in the treated articulation. The safety of this modality of management has been reported and hence the patients age should not be regarded as a criteria.

Adolescent↗
PubMed2004

Logistics of radioimmunotherapy with yttrium 90 ibritumomab tiuxetan (Zevalin).

Radioimmunotherapy is a promising new therapeutic option for the treatment of B-cell non-Hodgkin's lymphoma. Several monoclonal antibody and radionuclide conjugates, including I-131 tositumomab and Y-90 ibritumomab, have been investigated in clinical trials. Yttrium 90 ibritumomab tiuxetan (Zevalin; Biogen Idec Inc, Cambridge, MA) is indicated for the treatment of patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin's lymphoma, including patients with rituximab-refractory follicular non-Hodgkin's lymphoma. The ibritumomab tiuxetan regimen requires coordination of a multidisciplinary team on which the nuclear medicine physician (or radiation oncologist) plays a major role. The nuclear medicine physician (or radiation oncologist) is responsible for overseeing the administration of the radioimmunoconjugates and for interpreting the imaging scans to determine the expected or altered biodistribution of the radioimmunoconjugate.

Antibodies, Monoclonal↗
PubMed2004

Radioimmunotherapy with yttrium 90 ibritumomab tiuxetan (Zevalin): the role of the nuclear medicine physician.

Radioimmunotherapy is an emerging clinical treatment option for non-Hodgkin's lymphoma (NHL) that combines the target specificity of monoclonal antibodies with the cytotoxicity of targeted radiation, thereby avoiding the toxicity to normal organs associated with external beam radiotherapy. Yttrium 90 ibritumomab tiuxetan (Zevalin: Biogen Idec Inc, Cambridge, MA), the first radioimmunotherapeutic agent approved by the US Food and Drug Administration for the treatment of cancer, is indicated for the treatment of patients with relapsed or refractory low-grade, follicular, or transformed B-cell NHL, including patients with rituximab-refractory follicular NHL. It is likely that radioimmunotherapy will become a more common treatment option in NHL, necessitating the participation of nuclear medicine physicians on radioimmunotherapy treatment teams. The nuclear medicine physician plays a major role on the multidisciplinary treatment team, and is responsible for overseeing the administration of the radioimmunoconjugates and for interpreting the imaging scans to determine the biodistribution of the radioimmunoconjugate. It is important that nuclear medicine physicians be familiar with their role in administering radioimmunotherapy, the efficacy and safety of this treatment, and its logistics and radiation safety issues.

Antibodies, Monoclonal↗
PubMed2004

Imaging and dosing in radioimmunotherapy with yttrium 90 ibritumomab tiuxetan (Zevalin).

Yttrium 90 ibritumomab tiuxetan consists of the murine monoclonal antibody ibritumomab securely bound to the second-generation chelator tiuxetan, which attaches the high-energy pure beta emitter (90)Y, for therapy, or the gamma emitter indium 111, for imaging. The biodistribution of the therapeutic dose of (90)Y ibritumomab tiuxetan can be predicted by using an imaging dose of the antibody labeled with (111)In. Calculation of the therapeutic dose is simple and is based on patient weight and baseline platelet count: for patients with a platelet count of 150 x 10(9)/L or greater the dose of is 0.4 mCi/kg; for patients with mild thrombocytopenia (platelet count 100 x 10(9)/L to 149 x 10(9)/L) the dose is reduced to 0.3 mCi/kg; and the total dose should not exceed 32 mCi. Patients with platelet counts of less than 100 x 10(9)/L should not be treated with (90)Y ibritumomab tiuxetan. Imaging with (111)In ibritumomab tiuxetan is performed only to assess biodistribution of the radioimmunoconjugate. Uptake in sites of pathologic adenopathy, as well as other areas of lymphomatous involvement, is frequently seen on the images, but visualization of tumor uptake is not required to proceed with the therapeutic dose of (90)Y ibritumomab tiuxetan.

Antibodies, Monoclonal↗
PubMed2004

Radiation safety with yttrium 90 ibritumomab tiuxetan (Zevalin) radioimmunotherapy.

OBJECTIVES: To present pertinent issues involved in radiation safety in radioimmunotherapy with 90Y ibritumomab tiuxetan. DATA SOURCES: Published clinical trials of 90Y ibritumomab tiuxetan and secondary literature on radiation safety and radioimmunotherapy. CONCLUSION: Radioimmunotherapy with 90Y ibritumomab tiuxetan is safe and effective in the indicated population, and radiation safety requirements for caregivers and patients are minimal. Yttrium 90 ibritumomab is routinely and safety administered as an outpatient procedure; safety precautions are universal precautions, with the addition of acrylic shielding for the preparation and administration of the radiolabeled dose. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses play a key role in the multidisciplinary team. By observing universal precautions, and advising patients to do the same, oncology nurses may facilitate the safe and effective administration of the ibritumomab tiuxetan regimen.

Antibodies, Monoclonal↗
PubMed2004

Educating patients about radioimmunotherapy with yttrium 90 ibritumomab tiuxetan (Zevalin).

OBJECTIVES: To present the relevant information for the education of patients with B-cell non-Hodgkin's lymphoma (NHL) who are about to undergo radioimmunotherapy (RIT) with yttrium 90 (90Y) ibritumomab tiuxetan. DATA SOURCES: Published clinical trials of 90Y ibritumomab tiuxetan and secondary literature on radioimmunotherapy and NHL. CONCLUSION: RIT is an emerging therapeutic option for patients with B-cell NHL and promises to become more prevalent in clinical use. Patients need to understand the rationale for and schedule of treatments with this regimen and the necessary ongoing laboratory tests for monitoring myelosuppression, as well as possible adverse events that might occur after treatment. IMPLICATIONS FOR NURSING PRACTICE: Nursing professionals should be aware of the logistics of the ibritumomab tiuxetan regimen and with the data associated with it to educate patients and facilitate patient understanding and expectations.

Antibodies, Monoclonal↗
PubMed2006

Treatment with yttrium 90 ibritumomab tiuxetan at early relapse is safe and effective in patients with previously treated B-cell non-Hodgkin's lymphoma.

Yttrium 90 ((90)Y) ibritumomab tiuxetan (Zevalin), a radiolabeled monoclonal antibody against the CD20 antigen, is indicated for the treatment of patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin's lymphoma (NHL), including patients with rituximab-refractory follicular NHL. Data on 211 patients treated in four clinical trials were analysed to compare the efficacy and safety of (90)Y ibritumomab tiuxetan when it was used after the first relapse of NHL and when it was used after two or more prior therapies. Sixty-three patients (30%) were treated with (90)Y ibritumomab tiuxetan after their first relapse and 148 (70%) after two or more prior therapies. Demographics, disease characteristics and the frequency of adverse events were similar in all groups, with the exception of a higher rate of marrow involvement in first-relapse patients than in patients with two or more prior therapies (57% vs. 39%; P < 0.05). The complete response rate [confirmed (CR) and unconfirmed (Cru)] was higher in first-relapse patients (49% vs. 28%; P < 0.01), and the median time to progression (TTP) was longer (12.6 vs. 7.9 months; P < 0.05). In patients with follicular NHL, the differences were even more pronounced (CR/CRu: 51% vs. 28%; P < 0.01; TTP: 15.4 vs. 9.2 months; P < 0.05). (90)Y ibritumomab tiuxetan has substantial clinical benefits as a second-line therapy, especially in patients with follicular NHL. The quality of disease remissions obtained when (90)Y ibritumomab tiuxetan is administered after first relapse appears to be comparable with that observed with most chemotherapy regimens in first-relapse patients.

Adult↗
PubMed2006

A theoretical investigation into post-operative, intracavitary beta therapy of high-grade glioblastomas using yttrium-90.

Beta therapy with yttrium-90 (90Y) has recently been introduced as a post-operative intra-cavitary treatment for malignant glioblastoma, a generally radioresistant tumour for which cure rates with conventional radiotherapy are usually very disappointing. This short theoretical study investigates the conditions under which 90Y treatment might be most effective and assesses the likely amounts of activity which must be infused in order to successfully cope with the low radiosensitivities which characterize such tumours. The radiobiological and physical analysis is investigated using the linear quadratic (LQ) model and a range of possible scenarios for the distribution and density of the tumour cells surrounding the surgically formed cavities are considered. The results suggest that, in the absence of diffusion of 90Y from the cavity, the activity typically required for 50% tumour cure is well over 40 mCi (1480 MBq), this being considerably more than the clinically determined activities which may be tolerated. Suggestions are provided for improving the versatility of the model.

Apoptosis↗