Baechler Sébastien, Hobbs Robert F, Prideaux Andrew R, Recordon Mélanie, Bischof-Delaloye Angelika, Sgouros George
The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Cancer Biother Radiopharm. 2008 Oct;23(5):633-9. doi: 10.1089/cbr.2008.0506.
The aim of the present study was to retrospectively estimate the absorbed dose to kidneys in 17 patients treated in clinical practice with 90Y-ibritumomab tiuxetan for non-Hodgkin's lymphoma, using appropriate dosimetric approaches available.
The single-view effective point source method, including background subtraction, is used for planar quantification of renal activity. Since the high uptake in the liver affects the activity estimate in the right kidney, the dose to the left kidney serves as a surrogate for the dose to both kidneys. Calculation of absorbed dose is based on the Medical Internal Radiation Dose methodology with adjustment for patient kidney mass.
The median dose to kidneys, based on the left kidney only, is 2.1 mGy/MBq (range, 0.92-4.4), whereas a value of 2.5 mGy/MBq (range, 1.5-4.7) is obtained, considering the activity in both kidneys.
Irrespective of the method, doses to kidneys obtained in the present study were about 10 times higher than the median dose of 0.22 mGy/MBq (range, 0.00-0.95) were originally reported from the study leading to Food and Drug Administration approval. Our results are in good agreement with kidney-dose estimates recently reported from high-dose myeloablative therapy with 90Y-ibritumomab tiuxetan.
本研究的目的是回顾性评估17例在临床实践中接受90Y-替伊莫单抗治疗非霍奇金淋巴瘤患者的肾脏吸收剂量，采用现有的适当剂量测定方法。
单视野有效点源法，包括背景扣除，用于平面定量肾脏活性。由于肝脏的高摄取会影响右肾的活性估计，因此左肾的剂量可作为双肾剂量的替代。吸收剂量的计算基于医学内照射剂量方法，并根据患者肾脏质量进行调整。
仅基于左肾，肾脏的中位剂量为2.1 mGy/MBq（范围为0.92 - 4.4），而考虑双肾活性时，得到的值为2.5 mGy/MBq（范围为1.5 - 4.7）。
无论采用何种方法，本研究中获得的肾脏剂量比导致美国食品药品监督管理局批准的研究最初报告的中位剂量0.22 mGy/MBq（范围为0.00 - 0.95）高约10倍。我们的结果与最近关于90Y-替伊莫单抗高剂量清髓治疗的肾脏剂量估计结果高度一致。
