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中国[镥]镥-多柔比星治疗后的辐射暴露与防护建议。

Radiation exposure and protection advice after [Lu]Lu-DOTA-TATE therapy in China.

作者信息

Liu Fei, Li Panli, Xu Junyan, Zhang Jianping, Xu Xiaoping, Chen Zhihao, Qiao Ying, Liang Yun, Chen Jie, Song Shaoli

机构信息

Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.

出版信息

EJNMMI Res. 2024 Nov 28;14(1):119. doi: 10.1186/s13550-024-01185-4.


DOI:10.1186/s13550-024-01185-4
PMID:39607652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11604894/
Abstract

BACKGROUND: We conducted a study on radiation exposure in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) treated with [Lu]Lu-DOTA-TATE in China for the first time, aiming to provide guidance and reference for radiation protection in this regard. A total of 30 GEP-NENs patients who received [Lu]Lu-DOTA-TATE therapy were recruited in the study. We measured the external dose rate (EDR) values of each patient during the injection and 0-6 h post-administration period, as well as the radiation dose (RD) values to healthcare nurses and the surrounding environment. We performed a double exponential curve fitting and estimated the RD to the public from patients discharged at different times after [Lu]Lu-DOTA-TATE therapy. RESULTS: Among the 30 patients, 27 patients completed 4 cycles of [Lu]Lu-DOTA-TATE treatments, the estimated RD to the public indicated that for adult family members, children above 10 years old, children aged 3-10 and coworkers of the patients, patients could begin daily contact at least 24 h, 48 h, 144 h and 192 h after injection to ensure that the total RD values after four treatments not exceed the limit. During the hospitalization of patients receiving [Lu]Lu-DOTA-TATE, the cumulative dose received by the administering nurses and to the ward environment were both well below the national RD limits. CONCLUSIONS: This study conducted a fitting analysis of the decay pattern of EDR values in GEP-NENs patients undergoing [Lu]Lu-DOTA-TATE therapy, in order to establish guidelines for patient discharge timing and provide recommendations for radiation protection for the general public after patient discharge. Trial registration A Study Comparing Treatment With Lutetium[177Lu] Oxodotreotide Injection to Octreotide LAR in Patients With GEP-NETs, NCT05459844. https://clinicaltrials.gov/study/NCT05459844?cond=NCT05459844&rank=1 . Registered 5 July 2022.

摘要

背景:我们首次在中国对接受[镥]镥-多胺基多羧基配体-奥曲肽治疗的胃肠胰神经内分泌肿瘤(GEP-NENs)患者的辐射暴露情况进行了研究,旨在为这方面的辐射防护提供指导和参考。本研究共招募了30例接受[镥]镥-多胺基多羧基配体-奥曲肽治疗的GEP-NENs患者。我们测量了每位患者在注射期间及给药后0至6小时的外照射剂量率(EDR)值,以及医护人员和周围环境所接受的辐射剂量(RD)值。我们进行了双指数曲线拟合,并估算了[镥]镥-多胺基多羧基配体-奥曲肽治疗后不同时间出院患者对公众造成的辐射剂量。 结果:30例患者中,27例患者完成了4个周期的[镥]镥-多胺基多羧基配体-奥曲肽治疗,对公众的估算辐射剂量表明,对于成年家庭成员、10岁以上儿童、3至10岁儿童以及患者的同事,患者可在注射后至少24小时、48小时、144小时和192小时开始日常接触,以确保四次治疗后的总辐射剂量值不超过限值。在接受[镥]镥-多胺基多羧基配体-奥曲肽治疗的患者住院期间,给药护士和病房环境所接受的累积剂量均远低于国家辐射剂量限值。 结论:本研究对接受[镥]镥-多胺基多羧基配体-奥曲肽治疗的GEP-NENs患者外照射剂量率值的衰减模式进行了拟合分析, 以制定患者出院时间指南,并为患者出院后公众的辐射防护提供建议。试验注册一项比较镥[177Lu]奥曲肽注射液与奥曲肽长效注射剂治疗GEP-NETs患者的研究,NCT05459844。https://clinicaltrials.gov/study/NCT05459844?cond=NCT05459844&rank=1 。于2022年7月5日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/93ffdf929432/13550_2024_1185_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/1406590a50c6/13550_2024_1185_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/65c7269c3de9/13550_2024_1185_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/dfe9f79d9463/13550_2024_1185_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/c4c681ca00d3/13550_2024_1185_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/93ffdf929432/13550_2024_1185_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/1406590a50c6/13550_2024_1185_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/65c7269c3de9/13550_2024_1185_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/dfe9f79d9463/13550_2024_1185_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/c4c681ca00d3/13550_2024_1185_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a48c/11604894/93ffdf929432/13550_2024_1185_Fig5_HTML.jpg

相似文献

[1]
Radiation exposure and protection advice after [Lu]Lu-DOTA-TATE therapy in China.

EJNMMI Res. 2024-11-28

[2]
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[3]
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[5]
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Cancer Biother Radiopharm. 2022-4

[6]
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Eur J Nucl Med Mol Imaging. 2022-5

[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Al[F]F-NOTA-Octreotide Is Comparable to [Ga]Ga-DOTA-TATE for PET/CT Imaging of Neuroendocrine Tumours in the Latin-American Population.

Cancers (Basel). 2023-1-10

[2]
Enhancer of Zeste Homolog 2 (EZH2) Is a Marker of High-Grade Neuroendocrine Neoplasia in Gastroenteropancreatic and Pulmonary Tract and Predicts Poor Prognosis.

Cancers (Basel). 2022-6-8

[3]
Phase II trial demonstrates the efficacy and safety of individualized, dosimetry-based Lu-DOTATATE treatment of NET patients.

Eur J Nucl Med Mol Imaging. 2022-9

[4]
New Insights in PRRT: Lessons From 2021.

Front Endocrinol (Lausanne). 2022

[5]
EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands.

Eur J Nucl Med Mol Imaging. 2022-5

[6]
Peptide Receptor Radionuclide Therapy with [Lu]Lu-DOTA-TATE in Patients with Advanced GEP NENS: Present and Future Directions.

Cancers (Basel). 2022-1-24

[7]
Comparison of Two Types of Amino Acid Solutions on Lu-Dotatate Pharmacokinetics and Pharmacodynamics in Patients with Metastatic Gastroenteropancreatic Neuroendocrine Tumors.

Curr Radiopharm. 2022

[8]
Lu-Dotatate plus long-acting octreotide versus high‑dose long-acting octreotide in patients with midgut neuroendocrine tumours (NETTER-1): final overall survival and long-term safety results from an open-label, randomised, controlled, phase 3 trial.

Lancet Oncol. 2021-12

[9]
Practical kidney dosimetry in peptide receptor radionuclide therapy using [Lu]Lu-DOTATOC and [Lu]Lu-DOTATATE with focus on uncertainty estimates.

EJNMMI Phys. 2021-11-13

[10]
Efficacy and Safety of Lu-DOTATATE in Lung Neuroendocrine Tumors: A Bicenter study.

J Nucl Med. 2022-2

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