用包括177Lu在内的放射性药物治疗的患者的剂量测量建议
Pablo Mínguez Gabiña1, Nuria Carrasco Vela2, Leticia Irazola Rosales3
1Unidad de Protección Radiológica y Radiológica, Hospital Universitario de Cruces-Gurutzeta/Instituto de Investigación Sanitaria BioBizkaia, Barakaldo, Spain.
概括
本文档提供了对接受治疗的患者进行剂量测量的建议,这些患者接受了使用卢-177 (Lu) 放射性药物治疗,包括Lu-DOTA-TATE和Lu-PSMA-617. 它涉及针对个性化放射治疗的现行实践和监管要求.
科学领域:
- 核医学就是核医学.
- 辐射疗法 辐射疗法
- 医学物理 医学物理
背景情况:
- 两个关键的Lu放射性药物,Lu-DOTA-TATE和Lu-PSMA-617,分别已被批准用于治疗神经内分泌瘤和转移性割抵抗性前列腺癌 (mCRPC).
- 目前的法规要求对治疗目的的辐射剂量进行个性化规划和验证,目的是尽量减少对非目标组织的暴露.
- 标准治疗方案涉及两种药物的7.4 GBq固定循环,这表明治疗前缺乏个体剂量规划.
研究的目的:
- 在使用基于Lu的放射性药物治疗中,为患者剂量测量提供建议.
- 为使临床实践与放射治疗应用中个性化剂量计的监管要求保持一致.
- 引导医疗保健专业人员优化辐射输送和验证,以改善患者的治疗结果.
主要方法:
- 审查现行监管指南 (RD601/2019) 关于在放射治疗过程中的医学暴露.
- 对[177Lu-DOTA-TATE和[177Lu]Lu-PSMA-617的标准治疗方案进行分析.
- 根据ALARA (尽可能低的合理实现) 和治疗意图的原则制定建议.
主要成果:
- 目前[177Lu]Lu-DOTA-TATE和[177Lu]Lu-PSMA-617的治疗方案涉及固定活动周期,而不是个性化预治疗计划.
- 剂量计验证是可能的,尽管没有预处理规划.
- 该文件旨在弥合固定的剂量协议和个性化剂量测量的需要之间的差距.
结论:
- 对于Lu放射性药物疗法,需要标准化剂量测量建议.
- 实施剂量计验证可以提高这些治疗的安全性和有效性.
- 提供了建议,以支持符合监管预期的个性化患者剂量测量.
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