Assessments for High Dose Radionuclide Therapy Treatment Planning

Journal Article · Wed Oct 01 04:00:00 EDT 2003 · Radiation Protection Dosimetry, 105(1-4):581-586

DOI:https://doi.org/10.1093/oxfordjournals.rpd.a006307· OSTI ID:15005506

Fisher, Darrell R

Advances in the biotechnology of cell-specific targeting of cancer, and the increased number of clinical trials involving treatment of cancer patients with radiolabeled antibodies, peptides, and similar delivery vehicles have led to an increase in the number of high-dose radionuclide therapy procedures. Optimized radionuclide therapy for cancer treatment is based on the concept of absorbed dose to the dose-limiting normal organ or tissue. The limiting normal tissue is often the red marrow, but it may sometimes be lungs, liver, intestinal tract, or kidneys. Appropriate treatment planning requires assessment of radiation dose to several internal organs and tissues, and usually involves biodistribution studies in the patient using a tracer amount of radionuclide bound to the targeting agent and imaged at sequential time points using a planar gamma camera. Time-activity curves are developed from the imaging data for the major organs tissues of concern, for the whole body, and sometimes for selected tumors. Patient-specific factors often require that dose estimates be customized for each patient. The Food and Drug Administration regulates the experimental use of investigational new drugs and requires reasonable calculation of radiation absorbed dose to the whole body and to critical organs using methods prescribed by the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. Review of high-dose studies in the U.S. and elsewhere shows that 1) some studies are conducted with minimal dosimetry, 2) the marrow dose is difficult to establish and is subject to large uncertainties, and 3) despite the general availability of MIRD software, internal dosimetry methods are often inconsistent from one clinical center to another.

• Research Organization: Pacific Northwest National Laboratory (PNNL), Richland, WA (US)
• Sponsoring Organization: USDOE
• DOE Contract Number: AC05-76RL01830
• OSTI ID: 15005506
• Report Number(s): PNNL-SA-37552; 600306000
• Journal Information: Radiation Protection Dosimetry, 105(1-4):581-586, Journal Name: Radiation Protection Dosimetry, 105(1-4):581-586
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CLINICAL TRIALS
CRITICAL ORGANS
DOSIMETRY
GAMMA CAMERAS
NEOPLASMS
NUCLEAR MEDICINE
PLANNING
RADIATION DOSES
RADIOISOTOPES
THERAPY
US FDA
cancer treatment
high-dose
internal dosimetry
radionuclides
treatment planning