Comparative physical and pharmacologic characteristics of iodine-131 and yttrium-90: Implications for radioimmunotherapy for patients with non-Hodgkin's lymphoma
Comparative physical and pharmacologic characteristics of iodine-131 and yttrium-90: Implications for radioimmunotherapy for patients with non-Hodgkin's lymphoma
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DOI：
10.1081/cnv-120016421
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发表时间：
2003-01-01
影响因子：
2.4
通讯作者：
Goldsmith, SJ
中科院分区：
文献类型：
--
作者：
Leonard, JP;Siegel, JA;Goldsmith, SJ
放射免疫疗法（RIT）是复发/难治性非霍奇金淋巴瘤患者的一种有希望的新治疗选择。临床试验表明，碘-131 （I-131）和钇-90 （Y-90）都是适用于RIT的放射性核素。碘-131和Y-90在物理性质上有明显的不同，包括半衰期、路径长度、能量发射类型、细胞内稳定性和游离放射性核素靶向的器官。根据目前核管理委员会的指导方针，这两种放射性核素都可以在门诊环境中安全使用。I-131用于RIT的潜在优势包括可用性，稳定的化学性质，较长的半衰期，以及允许使用相同免疫偶联物进行剂量学研究和治疗的发射光谱。相比之下，Y-90与I-131相比具有更长的路径长度和更好的细胞内稳定性。因此，对于体积较大的疾病、血管化程度较差的实体肿瘤或靶向内化抗原的患者，钇-90可能优于I-131。虽然Y-90不发射伽马光子，但Y-90 RIT的剂量学研究可以使用替代放射性核素如铟-111进行。I-131和y -90标记的抗cd20抗体已被证明对治疗复发/难治性非霍奇金淋巴瘤有效。然而，需要进一步的研究来确定I-131和90Y的药理学差异是否与临床相关。
Radioimmunotherapy (RIT) is a promising new treatment option for patients with relapsed/refractory non-Hodgkin's lymphoma. Clinical trials have demonstrated that both iodine-131 (I-131) and yttrium-90 (Y-90) are suitable radionuclides for RIT. Iodine-131 and Y-90 differ markedly in their physical properties including half-life, path length, type of energy emissions, intracellular stability, and the organs targeted by the free radionuclide. Both radionuclides can be safely administered in the outpatient setting under current Nuclear Regulatory Commission guidelines. Potential advantages of I-131 for RIT include availability, stable chemistry, longer half-life, and an emission spectrum that allows for dosimetric studies and therapy with the same immunoconjugate. By contrast, Y-90 has a longer path length and superior intracellular stability compared with I-131. Yttrium-90 may therefore be preferable to I-131 for patients with bulky disease, poorly vascularized solid tumors, or when targeting internalized antigens. Although Y-90 emits no gamma photon, dosimetry studies for Y-90 RIT can be performed using a surrogate radionuclide such as indium-111. Both I-131- and Y-90-labeled anti-CD20 antibodies have demonstrated efficacy in treating relapsed/refractory non-Hodgkin's lymphoma. Further studies are needed, however, to determine if the differences in the pharmacology of I-131 and 90Y are clinically relevant.