Vriesendorp H M, Quadri S M, Andersson B S, Wyllie C T, Dicke K A
University of Texas, M. D. Anderson Cancer Center, Houston, USA.
Cancer. 1997 Dec 15;80(12 Suppl):2721-7. doi: 10.1002/(sici)1097-0142(19971215)80:12+<2721::aid-cncr51>3.3.co;2-l.
Indium-111 labeled antiferritin targets 95% of all Hodgkin's disease lesions with a diameter of 1 cm or more. Subsequent treatment with yttrium-90 labeled antiferritin secures a high response rate in patients with recurrent Hodgkin's disease.
A total of 87 patients were entered on one of three different yttrium-90 labeled antiferritin protocols. Recurrences after yttrium-90 treatment were analyzed. Nine patients were retreated with involved external beam radiation fields, selected with the help of indium-111 labeled antiferritin.
In single-agent yttrium-90 antiferritin studies, a response rate of more than 60% was found, with an average response duration of 6 months. One-third of the patients had recurrences in previously uninvolved areas. Repeat indium antiferritin scintigraphy allowed for the selection of new radiation fields for recurrences. In-field disease control was obtained for a median of 8 months, but new recurrences in new areas occurred. Chemotherapy or radiation therapy given immediately before antiferritin decreased tumor targeting with indium-111 labeled antiferritin.
Recurrences after radiolabeled antiferritin treatment are not due to radioresistant Hodgkin's disease. In contrast, Hodgkin's disease less than 1 cm in diameter is not targeted and not controlled by radiolabeled antiferritin. New multimodality regimens with a higher therapeutic ratio are needed for treatment of Hodgkin's disease with curative intent. Radiolabeled antiferritin can be incorporated in such regimens to secure better control of bulky Hodgkin's disease (>1 cm in diameter), but it should be given before chemotherapy or radiation therapy.
铟 - 111标记的抗铁蛋白可靶向95%直径1厘米及以上的所有霍奇金病病灶。随后用钇 - 90标记的抗铁蛋白进行治疗，可使复发性霍奇金病患者获得较高的缓解率。
共有87例患者纳入三种不同的钇 - 90标记抗铁蛋白方案之一。对钇 - 90治疗后的复发情况进行了分析。9例患者借助铟 - 111标记的抗铁蛋白选择受累野进行外照射放疗。
在单药钇 - 90抗铁蛋白研究中，缓解率超过60%，平均缓解持续时间为6个月。三分之一的患者在先前未受累区域出现复发。重复铟抗铁蛋白闪烁扫描可用于为复发选择新的放疗野。野内疾病控制的中位时间为8个月，但新区域出现了新的复发。在抗铁蛋白治疗前立即给予化疗或放疗会降低铟 - 111标记的抗铁蛋白对肿瘤的靶向性。
放射性标记抗铁蛋白治疗后的复发并非由于霍奇金病具有放射抗性。相反，直径小于1厘米的霍奇金病病灶不能被放射性标记抗铁蛋白靶向和控制。需要新的具有更高治疗比的多模式治疗方案来根治性治疗霍奇金病。放射性标记抗铁蛋白可纳入此类方案以更好地控制体积较大的霍奇金病（直径>1厘米），但应在化疗或放疗前给予。
