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门诊177Lu-奥曲肽放射性肽治疗神经内分泌肿瘤的辐射安全性

Radiation safety of outpatient 177Lu-octreotate radiopeptide therapy of neuroendocrine tumors.

作者信息

Calais Phillipe J, Turner J Harvey

机构信息

Department of Nuclear Medicine, Fremantle Hospital, The University of Western Australia, Alma Street, Fremantle, WA, 6160, Australia.

出版信息

Ann Nucl Med. 2014 Jul;28(6):531-9. doi: 10.1007/s12149-014-0843-8. Epub 2014 Apr 1.

Abstract

PURPOSE

To demonstrate the safety of outpatient 7.8 GBq (177)Lu-DOTA-tyr(3)-octreotate radiopeptide therapy of neuroendocrine tumors by measurement of radiation exposures of hospital personnel, carers and members of the public.

METHODS

Seventy-six patients with progressive, metastatic neuroendocrine tumors each received four cycles of prescribed activity of 7.8 GBq (177)Lu-octreotate at 8-week intervals, as an outpatient procedure. Cohorts comprising four patients were treated in one room, each patient remaining in hospital until radiation exposure from them was below the release limit of 25 μSv h(-1) at 1 m. On occasion, a single patient was treated in a single room. Radiation exposures of hospital staff and patient carers were monitored by personal dosimeter, and nearby areas monitored with a survey meter.

RESULTS

Mean whole-body radiation exposures per therapy day ranged from 8 μSv (physicist) to 33 μSv (nurse), with exposures to personnel, carers and members of the public well within the limits recommended by the International Commission on Radiological Protection. Patients excreted a mean of 46 % of the total administered activity of (177)Lu-octreotate within 4 h of therapy.

CONCLUSION

Lutetium-177-octreotate radiopeptide therapy of neuroendocrine tumors can be safely performed as an outpatient treatment.

摘要

目的

通过测量医院工作人员、护理人员和公众的辐射暴露情况,证明门诊给予7.8GBq(177)镥-奥曲肽放射性肽治疗神经内分泌肿瘤的安全性。

方法

76例进展期转移性神经内分泌肿瘤患者,每例均接受4个周期的规定活度7.8GBq(177)镥-奥曲肽治疗,治疗间隔为8周,在门诊进行。每组4例患者在一个房间接受治疗,每位患者留在医院,直到其在距离1米处的辐射暴露低于25μSv h-1的出院限值。有时,单例患者在单人房间接受治疗。医院工作人员和患者护理人员的辐射暴露通过个人剂量计进行监测,附近区域用巡测仪进行监测。

结果

每个治疗日的全身平均辐射暴露范围为8μSv(物理学家)至33μSv(护士),工作人员、护理人员和公众的暴露均远低于国际放射防护委员会建议的限值。患者在治疗后4小时内平均排泄出所给予的(177)镥-奥曲肽总活度的46%。

结论

神经内分泌肿瘤的镥-177-奥曲肽放射性肽治疗可作为门诊治疗安全进行。

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