Oyen W J G, Bodei L, Giammarile F, Maecke H R, Tennvall J, Luster M, Brans B
Therapy Committee of the European Association of Nuclear Medicine, Hollandstrasse 14 / Mezzanine, A-1020 Vienna, Austria.
Ann Oncol. 2007 Nov;18(11):1782-92. doi: 10.1093/annonc/mdm111. Epub 2007 Apr 13.
In recent years, a number of new developments in targeted therapies using radiolabeled compounds have emerged. New developments and insights in radioiodine treatment of thyroid cancer, treatment of lymphoma and solid tumors with radiolabeled monoclonal antibodies (mAbs), the developments in the application of radiolabeled small receptor-specific molecules such as meta-iodobenzylguanidine and peptides and the position of locoregional treatment in malignant involvement of the liver are reviewed. The introduction of recombinant human thyroid-stimulating hormone and the possibility to enhance iodine uptake with retinoids has changed the radioiodine treatment protocol of patients with thyroid cancer. Introduction of radiolabeled mAbs has provided additional treatment options in patients with malignant lymphoma, while a similar approach proves to be cumbersome in patients with solid tumors. With radiolabeled small molecules that target specific receptors on tumor cells, high radiation doses can be directed to tumors in patients with disseminated disease. Radiolabeled somatostatin derivatives for the treatment of neuroendocrine tumors are the role model for this approach. Locoregional treatment with radiopharmaceuticals of patients with hepatocellular carcinoma or metastases to the liver may be used in inoperable cases, but may also be of benefit in a neo-adjuvant or adjuvant setting. Significant developments in the application of targeted radionuclide therapy have taken place. New treatment modalities have been introduced in the clinic. The concept of combining therapeutic radiopharmaceuticals with other treatment modalities is more extensively explored.
近年来，使用放射性标记化合物的靶向治疗出现了一些新进展。本文综述了甲状腺癌放射性碘治疗、放射性标记单克隆抗体（mAb）治疗淋巴瘤和实体瘤的新进展与新见解、放射性标记的小受体特异性分子如间碘苄胍和肽的应用进展以及局部区域治疗在肝脏恶性受累中的地位。重组人促甲状腺激素的引入以及使用维甲酸增强碘摄取的可能性改变了甲状腺癌患者的放射性碘治疗方案。放射性标记单克隆抗体的引入为恶性淋巴瘤患者提供了额外的治疗选择，而类似的方法在实体瘤患者中却很麻烦。对于患有播散性疾病的患者，使用靶向肿瘤细胞上特定受体的放射性标记小分子，可以将高辐射剂量导向肿瘤。用于治疗神经内分泌肿瘤的放射性标记生长抑素衍生物是这种方法的典范。肝细胞癌或肝转移患者的放射性药物局部区域治疗可用于无法手术的病例，但在新辅助或辅助治疗中也可能有益。靶向放射性核素治疗的应用取得了重大进展。临床上引入了新的治疗方式。治疗性放射性药物与其他治疗方式联合使用的概念得到了更广泛的探索。
