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Optimizing Dose and...
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Hersi, Abdi-FatahUppsala universitet,Centrum för klinisk forskning, Västerås,Institutionen för kirurgiska vetenskaper,Uppsala Univ, Ctr Clin Res, Reg Vastmanland, S-72189 Västerås, Sweden.;Vastmanlands Hosp, Dept Surg, S-72189 Västerås, Sweden.
(author)
Optimizing Dose and Timing in Magnetic Tracer Techniques for Sentinel Lymph Node Detection in Early Breast Cancers: The Prospective Multicenter SentiDose Trial
- Article/chapterEnglish2021
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LIBRIS-ID:oai:gup.ub.gu.se/305758
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https://gup.ub.gu.se/publication/305758URI
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https://doi.org/10.3390/cancers13040693DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-194210URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-174394URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-440420URI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Funding Agencies|Uppsala University; Vastmanland Cancer Foundation
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Simple Summary Superparamagnetic iron oxide (SPIO) nanoparticles have comparable performance to the combination of radioisotope and blue dye (RI + BD) for sentinel lymph node (SLN) biopsy in breast cancer. In this multicenter prospective study, lower SPIO doses (undiluted 1.5 vs. 1.0 mL) in different timeframes (perioperative vs. 1-7 days preoperative) and injection sites (subareolar vs. peritumoral) were compared to the previous standard (diluted 2.0 mL perioperatively) from the earlier Nordic trial. RI + BD were co-administered as background. In total, 534 patients were analyzed. SPIO SLN detection rates were similar (97.5% vs. 100% vs. 97.6%, p = 0.11) and respectively non-inferior to the dual technique. Significantly more SLNs were retrieved in the preoperative 1.0 mL cohort compared with 1.5 mL and the Nordic cohorts (2.18 vs. 1.85 vs. 1.83, p = 0.003). Thus, SPIO at 1.5 and 1.0 mL was non-inferior to both Sienna+(R) and the dual technique for SLN detection. Superparamagnetic iron oxide nanoparticles (SPIO) are non-inferior to radioisotope and blue dye (RI + BD) for sentinel lymph node (SLN) detection. Previously, 2 mL SPIO (Sienna+(R)) in 3 mL NaCl was used. In this dose-optimizing study, lower doses of a new refined SPIO solution (Magtrace(R)) (1.5 vs. 1.0 mL) were tested in different timeframes (0-24 h perioperative vs. 1-7 days preoperative) and injections sites (subareolar vs. peritumoral). Two consecutive breast cancer cohorts (n = 328) scheduled for SLN-biopsy were included from 2017 to 2019. All patients received isotope +/- blue dye as back-up. SLNs were identified primarily with the SentiMag(R) probe and thereafter a gamma-probe. The primary endpoint was SLN detection rate with SPIO. Analyses were performed as a one-step individual patient-level meta-analysis using patient-level data from the previously published Nordic Trial (n = 206) as a third, reference cohort. In 534 patients, the SPIO SLN detection rates were similar (97.5% vs. 100% vs. 97.6%, p = 0.11) and non-inferior to the dual technique. Significantly more SLNs were retrieved in the preoperative 1.0 mL cohort compared with 1.5 and the 2.0 mL cohorts (2.18 vs. 1.85 vs. 1.83, p = 0.003). Lower SPIO volumes injected up to 7 days before the operation have comparable efficacy to standard SPIO dose and RI + BD for SLN detection.
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Pistiolis, L.Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Univ Gothenburg, Sahlgrenska Univ Hosp, Inst Clin Sci, Dept Surg,Sahlgrenska Acad, S-41345 Gothenburg, Sweden.
(author)
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Luberth, Carlos DussanRegion Östergötland, Kirurgiska kliniken US,Linköping Univ Hosp, Dept Surg, S-58185 Linköping, Sweden.(Swepub:liu)n/a
(author)
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Vikhe Patil, EvaLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,Linköping Univ Hosp, Dept Surg, S-58185 Linköping, Sweden.(Swepub:liu)evavi61
(author)
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Nilsson, FredrikUmeå universitet,Kirurgi,Umeå Univ Hosp, Dept Surg & Perioperat Sci, S-90187 Umeå, Sweden.(Swepub:umu)frni0035
(author)
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Mohammed, I.Kalmar Cty Hosp, Dept Surg, S-39185 Kalmar, Sweden.
(author)
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Olofsson Bagge, Roger,1978Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Univ Gothenburg, Sahlgrenska Univ Hosp, Inst Clin Sci, Dept Surg,Sahlgrenska Acad, S-41345 Gothenburg, Sweden.(Swepub:gu)xoloro
(author)
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Wärnberg, FredrikGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Univ Gothenburg, Sahlgrenska Univ Hosp, Inst Clin Sci, Dept Surg,Sahlgrenska Acad, S-41345 Gothenburg, Sweden.;Uppsala Univ, Dept Surg Sci, S-75185 Uppsala, Sweden.(Swepub:gu)xwarnf
(author)
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Eriksson, StaffanUppsala universitet,Centrum för klinisk forskning, Västerås,Gastrointestinalkirurgi,Uppsala Univ, Ctr Clin Res, Reg Vastmanland, S-72189 Västerås, Sweden.;Vastmanlands Hosp, Dept Surg, S-72189 Västerås, Sweden.(Swepub:uu)staer951
(author)
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Karakatsanis, AndreasUppsala universitet,Endokrinkirurgi(Swepub:uu)andka774
(author)
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Uppsala universitetCentrum för klinisk forskning, Västerås
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In:Cancers: MDPI AG13:42072-6694
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