Relevance of external beam dose-response relationships to kidney toxicity associated with radionuclide therapy
Relevance of external beam dose-response relationships to kidney toxicity associated with radionuclide therapy
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DOI：
10.1089/1084978041425025
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发表时间：
2004-06-01
影响因子：
3.4
通讯作者：
O'Donoghue, J
中科院分区：
文献类型：
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作者：
O'Donoghue, J
随着较小的分子载体和放射性金属在靶向放射性核素治疗中的使用越来越普遍，肾脏作为剂量限制器官的重要性可能会增加。外照射治疗 (XRT) 肾脏照射的数据表明肾脏对放射敏感。局部 XRT、全身照射 (TBI) 和放射性核素治疗之间的放射性肾病治疗后特征似乎相似。对于均匀的肾脏照射，局部 XRT 的耐受剂量似乎约为 2 Gy 分数中的 15-17 Gy，而当在骨髓移植方案中作为 TBI 全身递送辐射时，耐受剂量可能低于此值（类似于 2 Gy 分数中的 12 Gy）。动物研究表明，α/β 参数为 1.5-3 Gy 的线性二次 (LQ) 模型似乎充分描述了肾脏的 XRT 分割敏感性，每次分割的剂量低至约 1 Gy，但可能会低估小于此大小的分割大小的有效性。动物研究还阐明了放射性肾病表现时间的剂量依赖性，并表明放射性肾病可以通过药物手段缓解。
The importance of the kidney as a dose-limiting organ is likely to increase as smaller molecular vectors and radiometals become more commonly used in targeted radionuclide therapy. Data derived from kidney irradiation by external-beam therapy (XRT) indicate that the kidney is radiosensitive. The features of radiation nephropathy seen post-treatment appear similar between local XRT, total-body irradiation (TBI), and radionuclide therapy. For uniform kidney irradiation, tolerance doses appear to be approximately 15-17 Gy in 2 Gy fractions for local XRT and probably less than this (similar to12 Gy in 2 Gy fractions) when radiation is delivered systemically as TBI in the context of bone marrow transplant protocols. Animal studies indicate that the linear quadratic (LQ) model with an alpha/beta parameter of 1.5-3 Gy seems to adequately describe the XRT fractionation sensitivity of kidney for doses per fraction down to approximately 1 Gy, but may underestimate the effectiveness of fraction sizes less than this. Animal studies have also clarified the dose-dependency of the time to expression of radiation nephropathy and have indicated that radiation nephropathy may be alleviated by pharmacological means.