Huizing Daphne Merel Valerie, de Wit-van der Veen Berlinda Jantina, Verheij Marcel, Stokkel Marcellus Petrus Maria
Department of Nuclear Medicine, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Department of Radiation Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
EJNMMI Res. 2018 Aug 29;8(1):89. doi: 10.1186/s13550-018-0443-z.
The main challenge for systemic radiation therapy using radiopharmaceuticals (SRT) is to optimise the dose delivered to the tumour, while minimising normal tissue irradiation. Dosimetry could help to increase therapy response and decrease toxicity after SRT by individual treatment planning. Peptide receptor radionuclide therapy (PRRT) is an accepted SRT treatment option for irresectable and metastatic neuroendocrine tumours (NET). However, dosimetry in PRRT is not routinely performed, mainly due to the lack of evidence in literature and clinical implementation difficulties. The goal of this review is to provide insight in dosimetry methods and requirements and to present an overview of clinical aspects of dosimetry in PRRT for NET.
A PubMed query including the search criteria dosimetry, radiation dose, peptide receptor radionuclide therapy, and radionuclide therapy was performed. Articles were selected based on title and abstract, and description of dosimetric approach.
A total of 288 original articles were included. The most important dosimetry methods, their main advantages and limitations, and implications in the clinical setting are discussed. An overview of dosimetry in clinical studies regarding PRRT treatment for NET is provided.
Clinical dosimetry in PRRT is feasible and can result in improved treatment outcomes. Current clinical dosimetry studies focus on safety and apply non-voxel-based dosimetry methods. Personalised treatment using sophisticated dosimetry methods to assess tumour and normal tissue uptake in clinical trials is the next step towards routine dosimetry in PRRT for NET.
使用放射性药物的全身放射治疗（SRT）的主要挑战在于优化肿瘤的辐射剂量，同时尽量减少对正常组织的照射。剂量测定有助于通过个体化治疗计划提高SRT后的治疗反应并降低毒性。肽受体放射性核素治疗（PRRT）是不可切除和转移性神经内分泌肿瘤（NET）公认的SRT治疗选择。然而，PRRT中的剂量测定并未常规进行，主要是由于文献中缺乏证据以及临床实施困难。本综述的目的是深入了解剂量测定方法和要求，并概述PRRT治疗NET时剂量测定的临床方面。
进行了一次PubMed查询，搜索标准包括剂量测定、辐射剂量、肽受体放射性核素治疗和放射性核素治疗。根据标题、摘要和剂量测定方法的描述选择文章。
共纳入288篇原创文章。讨论了最重要的剂量测定方法、它们的主要优点和局限性以及在临床环境中的意义。提供了关于PRRT治疗NET的临床研究中剂量测定的概述。
PRRT中的临床剂量测定是可行的，并且可以改善治疗结果。当前的临床剂量测定研究侧重于安全性，并应用基于非体素的剂量测定方法。在临床试验中使用复杂的剂量测定方法评估肿瘤和正常组织摄取的个体化治疗是PRRT治疗NET常规剂量测定的下一步。
