MIRD Dose Estimate Report No. 20: Radiation Absorbed-Dose Estimates for 111In- and 90Y-Ibritumomab Tiuxetan
MIRD Dose Estimate Report No. 20: Radiation Absorbed-Dose Estimates for 111In- and 90Y-Ibritumomab Tiuxetan
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DOI：
10.2967/jnumed.108.057331
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发表时间：
2009-04-01
影响因子：
9.3
通讯作者：
Meredith, Ruby F.
中科院分区：
文献类型：
--
作者：
Fisher, Darrell R.;Shen, Sui;Meredith, Ruby F.
吸收剂量计算为评价放射性药物给药的生物学效应提供了科学依据。在癌症治疗中，辐射剂量测定支持治疗计划、剂量反应分析、治疗有效性预测和患者医疗记录的完整性。在本研究中，我们评价了静脉注射In-111-和Y-90-替伊莫单抗的器官辐射吸收剂量。研究方法：10例非霍奇金淋巴瘤患者（6例男性和4例女性）在3个不同的医疗中心接受治疗，给予示踪剂In-111-替伊莫单抗，并在5个时间点使用平面闪烁照相机成像和CT器官体积测定法进行评估，以确定患者特异性器官生物学特性和剂量测定。基于透射扫描或透射测量的显式衰减校正提供了7个主要器官、全身和剩余组织中In-111给药活性随时间推移通过完全衰减的分数。绘制时间-放射性曲线，使用MIRD方法和实现软件计算辐射剂量。结果如下：报告了10名癌症患者接受In-111和Y-90-替伊莫单抗治疗后24个器官和全身的平均辐射吸收剂量。给出了7个主要来源器官、剩余组织和全身的生物摄取和保留数据。将该方法计算的中位吸收剂量值与先前发表的替伊莫单抗剂量测定和产品包装说明书进行比较。结论：在高剂量放射免疫治疗中，当治疗计划的目标是通过将任何关键正常器官的辐射剂量限制在其最大耐受值来安全地实现疾病治愈时，患者特异性剂量测定的重要性变得显而易见。与当前包装说明书相比，我们发现肾脏中的中位吸收剂量差异为24倍，红骨髓中为1.8倍，肝脏中为0.65倍，肠壁中为0.077倍，肺中为0.30倍，脾脏中为0.46倍，心脏壁中为0.34倍。
Absorbed-dose calculations provide a scientific basis for evaluating the biologic effects associated with administered radiopharmaceuticals. In cancer therapy, radiation dosimetry supports treatment planning, dose-response analyses, predictions of therapy effectiveness, and completeness of patient medical records. In this study, we evaluated the organ radiation absorbed doses from intravenously administered In-111- and Y-90-ibritumomab tiuxetan. Methods: Ten patients (6 men and 4 women) with non-Hodgkin lymphoma, cared for at 3 different medical centers, were administered the tracer In-111- ibritumomab tiuxetan and assessed using planar scintillation camera imaging at 5 time points and CT-organ volumetrics to determine patient-specific organ biokinetics and dosimetry. Explicit attenuation correction based on the transmission scan or transmission measurements provided the fraction of In-111- administered activity in 7 major organs, the whole body, and remainder tissues over time through complete decay. Time-activity curves were constructed, and radiation doses were calculated using MIRD methods and implementing software. Results: Mean radiation absorbed doses for In-111- and for Y-90-ibritumomab tiuxetan administered to 10 cancer patients are reported for 24 organs and the whole body. Biologic uptake and retention data are given for 7 major source organs, remainder tissues, and the whole body. Median absorbed dose values calculated by this method were compared with previously published dosimetry for ibritumomab tiuxetan and the product package insert. Conclusion: In high-dose radioimmunotherapy, the importance of patient-specific dosimetry becomes obvious when the objective of treatment planning is to achieve disease cures, safely, by limiting radiation dose to any critical normal organ to its maximum tolerable value. Compared with the current package insert, we found differences in median absorbed dose by multiples of 24 in the kidneys, 1.8 in the red marrow, 0.65 in the liver, 0.077 in the intestinal wall, 0.30 in the lungs, 0.46 in the spleen, and 0.34 in the heart wall.