Pandit-Taskar Neeta, Iravani Amir, Lee Dan, Jacene Heather, Pryma Dan, Hope Thomas, Saboury Babak, Capala Jacek, Wahl Richard L
Memorial Sloan Kettering Cancer Center, New York, New York;
Washington University School of Medicine, St. Louis, Missouri.
J Nucl Med. 2021 Dec;62(Suppl 3):60S-72S. doi: 10.2967/jnumed.121.262977.
The use of radiopharmaceutical therapies (RPTs) in the treatment of cancers is growing rapidly, with more agents becoming available for clinical use in last few years and many new RPTs being in development. Dosimetry assessment is critical for personalized RPT, insofar as administered activity should be assessed and optimized in order to maximize tumor-absorbed dose while keeping normal organs within defined safe dosages. However, many current clinical RPTs do not require patient-specific dosimetry based on current Food and Drug Administration-labeled approvals, and overall, dosimetry for RPT in clinical practice and trials is highly varied and underutilized. Several factors impede rigorous use of dosimetry, as compared with the more convenient and less resource-intensive practice of empiric dosing. We review various approaches to applying dosimetry for the assessment of activity in RPT and key clinical trials, the extent of dosimetry use, the relative pros and cons of dosimetry-based versus fixed activity, and practical limiting factors pertaining to current clinical practice.
放射性药物疗法（RPTs）在癌症治疗中的应用正在迅速增长，在过去几年中有更多药物可供临床使用，并且许多新的RPTs正在研发中。剂量学评估对于个性化RPT至关重要，因为应评估和优化给药活度，以便在将正常器官保持在规定的安全剂量范围内的同时，使肿瘤吸收剂量最大化。然而，根据美国食品药品监督管理局目前批准的标签，许多当前临床RPTs不需要基于患者特异性的剂量学，总体而言，临床实践和试验中RPT的剂量学差异很大且未得到充分利用。与经验性给药这种更方便且资源消耗较少的做法相比，有几个因素阻碍了剂量学的严格使用。我们回顾了将剂量学应用于评估RPT和关键临床试验中的活度的各种方法、剂量学的使用程度、基于剂量学与固定活度的相对优缺点，以及与当前临床实践相关的实际限制因素。
