Variations in the practice of molecular radiotherapy and implementation of dosimetry: results from a European survey
Variations in the practice of molecular radiotherapy and implementation of dosimetry: results from a European survey
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DOI：
10.1186/s40658-017-0193-4
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发表时间：
2017-12-04
期刊：
影响因子：
4
通讯作者：
Flux, Glenn
中科院分区：
文献类型：
--
作者：
Gleisner, Katarina Sjogreen;Spezi, Emiliano;Flux, Glenn
背景：目前，分子放射治疗(MRT)中剂量学的实施还没有得到很好的研究，鉴于理事会指令(2013/59/Eurtom)，有必要了解当前基于剂量学的MRT在临床实践和研究中的可用性。这项研究的目的是评估欧洲国家目前MRT和剂量学的实践。方法：向欧洲国家分发电子问卷。这涉及了18种明确考虑的疗法，对于每种疗法，都包括了一组类似的问题。问题涉及2015年的患者数量和治疗、医学专科和医学物理学家的参与、吸收剂量计划的实施、治疗后成像和剂量学、以及治疗处方的基础。结果：来自26个国家和208家医院的回复，共实施42853项治疗。最常见的治疗方法是I-131-NaI治疗良性甲状腺疾病和成人甲状腺切除术。32%的应答者报告说，医学物理学家的参与(平均在所有18种疗法中)要么是少数，要么从未参与。报告剂量学总是/多数被包括在内的应答者的百分比在不同的治疗方法中不同，显示的中位数为36%。其中以Lu-177-PSMA治疗(100%)、Y-90玻璃微球(84%)和树脂微球(82%)、I-131-MIBG(59%)和I-131-NaI(54%)治疗效果最好。大多数治疗都是基于固定活动方案开出的。Y-90微球治疗肝脏的吸收剂量处方数量最多(树脂和玻璃分别为和96%)，I-131-NaI治疗良性甲状腺疾病(38%)，I-131-MIBG治疗神经母细胞瘤(18%)。结论：欧洲各地的MRT实践和不同治疗方法存在很大差异，包括医学物理学家的参与程度和剂量学指导治疗的实施。
Background: Currently, the implementation of dosimetry in molecular radiotherapy (MRT) is not well investigated, and in view of the Council Directive (2013/59/Euratom), there is a need to understand the current availability of dosimetry-based MRT in clinical practice and research studies. The aim of this study was to assess the current practice of MRT and dosimetry across European countries.Methods: An electronic questionnaire was distributed to European countries. This addressed 18 explicitly considered therapies, and for each therapy, a similar set of questions were included. Questions covered the number of patients and treatments during 2015, involvement of medical specialties and medical physicists, implementation of absorbed dose planning, post-therapy imaging and dosimetry, and the basis of therapy prescription.Results: Responses were obtained from 26 countries and 208 hospitals, administering in total 42,853 treatments. The most common therapies were I-131-NaI for benign thyroid diseases and thyroid ablation of adults. The involvement of a medical physicist (mean over all 18 therapies) was reported to be either minority or never by 32% of the responders. The percentage of responders that reported that dosimetry was included on an always/majority basis differed between the therapies and showed a median value of 36%. The highest percentages were obtained for Lu-177-PSMA therapy (100%), Y-90 microspheres of glass (84%) and resin (82%), I-131-mIBG for neuroblastoma (59%), and I-131-NaI for benign thyroid diseases (54%). The majority of therapies were prescribed based on fixed-activity protocols. The highest number of absorbed-dose based prescriptions were reported for Y-90 microsphere treatments in the liver (64% and 96% of responses for resin and glass, respectively), I-131-NaI treatment of benign thyroid diseases (38% of responses), and for I-131-mIBG treatment of neuroblastoma (18% of responses).Conclusions: There is a wide variation in MRT practice across Europe and for different therapies, including the extent of medical-physicist involvement and the implementation of dosimetry-guided treatments.