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EANM 剂量学委员会关于 177Lu 标记的生长抑素受体和 PSMA 靶向配体剂量学的建议。

EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands.

机构信息

Medical Radiation Physics, Clinical Sciences Lund, Lund University, Lund, Sweden.

Université de Nantes, CNRS, Inserm, Oniris, CRCINA, Nantes, France.

出版信息

Eur J Nucl Med Mol Imaging. 2022 May;49(6):1778-1809. doi: 10.1007/s00259-022-05727-7. Epub 2022 Mar 14.

Abstract

The purpose of the EANM Dosimetry Committee is to provide recommendations and guidance to scientists and clinicians on patient-specific dosimetry. Radiopharmaceuticals labelled with lutetium-177 (177Lu) are increasingly used for therapeutic applications, in particular for the treatment of metastatic neuroendocrine tumours using ligands for somatostatin receptors and prostate adenocarcinoma with small-molecule PSMA-targeting ligands. This paper provides an overview of reported dosimetry data for these therapies and summarises current knowledge about radiation-induced side effects on normal tissues and dose-effect relationships for tumours. Dosimetry methods and data are summarised for kidneys, bone marrow, salivary glands, lacrimal glands, pituitary glands, tumours, and the skin in case of radiopharmaceutical extravasation. Where applicable, taking into account the present status of the field and recent evidence in the literature, guidance is provided. The purpose of these recommendations is to encourage the practice of patient-specific dosimetry in therapy with 177Lu-labelled compounds. The proposed methods should be within the scope of centres offering therapy with 177Lu-labelled ligands for somatostatin receptors or small-molecule PSMA.

摘要

欧洲核医学协会剂量学委员会的宗旨是就患者特异性剂量学向科学家和临床医生提供建议和指导。用镥-177(177Lu)标记的放射性药物越来越多地用于治疗应用,特别是用于治疗使用生长抑素受体配体的转移性神经内分泌肿瘤和使用小分子 PSMA 靶向配体的前列腺腺癌。本文概述了这些治疗方法的报告剂量学数据,并总结了关于正常组织放射性副作用和肿瘤剂量效应关系的现有知识。总结了肾脏、骨髓、唾液腺、泪腺、垂体、肿瘤和放射性药物外渗时皮肤的剂量学方法和数据。在适用的情况下,考虑到该领域的现状和文献中的最新证据,提供了指导。这些建议的目的是鼓励在使用 177Lu 标记化合物进行治疗时进行患者特异性剂量学。所提出的方法应在提供用生长抑素受体配体或小分子 PSMA 进行 177Lu 标记的治疗的中心范围内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1dc/9015994/943332a9a18a/259_2022_5727_Fig1_HTML.jpg

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