Cremonesi M, Ferrari M, Di Dia A, Botta F, De Cicco C, Bodei L, Paganelli G
European Institute of Oncology, Milan, Italy.
Q J Nucl Med Mol Imaging. 2011 Apr;55(2):155-67.
Peptide receptor radionuclide therapy (PRRT) has been constantly evolving over the last decade, providing successful results in the treatment of tumors expressing somatostatin receptors, especially with 90Y -- and 177Lu -- radiolabelled peptides. Recent and/or ongoing studies assure new perspectives to come. Dosimetry represents a precious guide for the selection of radionuclides and peptides, for protocol settings, for toxicity prevention and therapy optimization. Thus, reliable and personalized dosimetry is more and more requested. This paper reviews the important advances recently obtained in the dosimetric methods that have been applied to this therapy. Special emphasis has been given to the impact derived (or derivable in the next future) from more refined dose evaluations focused on the kidneys and the red marrow. The possibility of improving the accuracy of dosimetry represents a further challenge for this therapy. Following the preliminary correlation observed between the biological effective dose and the probability of renal injury, more reliable dose estimates could definitively enhance the predicitivity of the radiobiological effects, for toxicity prevention as well as for tumor control.
在过去十年中，肽受体放射性核素治疗（PRRT）一直在不断发展，在治疗表达生长抑素受体的肿瘤方面取得了成功，特别是使用90Y和177Lu放射性标记的肽。近期和/或正在进行的研究确保了新的前景。剂量测定是选择放射性核素和肽、制定方案、预防毒性和优化治疗的宝贵指南。因此，对可靠且个性化的剂量测定的需求越来越大。本文综述了最近在应用于该治疗的剂量测定方法方面取得的重要进展。特别强调了更精确的剂量评估对肾脏和红骨髓产生的（或在不久的将来可能产生的）影响。提高剂量测定准确性的可能性是该治疗面临的又一挑战。根据观察到的生物有效剂量与肾损伤概率之间的初步相关性，更可靠的剂量估计最终可以提高放射生物学效应的预测性，用于预防毒性以及控制肿瘤。
