Department of Nuclear Medicine, Fremantle Hospital, The University of Western Australia, Alma Street, Fremantle, WA, 6160, Australia.
Ann Nucl Med. 2012 May;26(4):289-97. doi: 10.1007/s12149-011-0566-z. Epub 2012 Jan 7.
In the beginning, nuclear medicine was radionuclide therapy, which has evolved into molecular tumour-targeted control of metastatic cancer. Safe, efficacious, clinical practice of therapeutic nuclear oncology may now be based upon accurate personalised dosimetry by quantitative gamma SPECT/CT imaging to prescribe tumoricidal activities without critical organ toxicity. Preferred therapy radionuclides possess gamma emission of modest energy and abundance to enable quantitative SPECT/CT imaging for calculation of the beta therapy dosimetry, without radiation exposure risk to hospital personnel, carers, family or members of the public. The safety of outpatient radiopharmaceutical therapy of cancer with Iodine-131, Samarium-153, Holmium-166, Rhenium-186, Rhenium-188, Lutetium-177 and Indium-111 is reviewed. Measured activity release rates and radiation exposure to carers and the public are all within recommendations and guidelines of international regulatory agencies and, when permitted by local regulatory authorities allow cost-effective, safe, outpatient radionuclide therapy of cancer without isolation in hospital.
起初，核医学是放射性核素治疗，现已演变为针对转移性癌症的分子靶向肿瘤控制。安全、有效、基于准确的个体化剂量测定的治疗核医学临床实践，现在可通过定量伽马 SPECT/CT 成像来规定肿瘤杀伤活性，而不会产生危及重要器官的毒性。首选的治疗性放射性核素具有适度能量和丰度的γ发射，能够进行定量 SPECT/CT 成像，以计算β治疗剂量，而不会对医院工作人员、护理人员、家属或公众造成辐射暴露风险。对接受碘-131、钐-153、钬-166、铼-186、铼-188、镥-177 和铟-111 放射性药物治疗癌症的门诊安全性进行了回顾。对护理人员和公众的放射性核素实际释放率和辐射暴露都在国际监管机构的建议和指南范围内，而且在当地监管当局允许的情况下，可进行具有成本效益、安全的门诊癌症放射性核素治疗，而无需在医院隔离。
