^(177)Lu-奥曲肽治疗神经内分泌肿瘤肾脏吸收剂量估算  

Estimation of renal absorbed doses in the treatment of neuroendocrine tumors using ^(177)Lu-DOTA-TATE

作　　者：王风[1] 潘永祥 丁立新 朱华[1] 于江媛[1] 杨志[1] Wang Feng;Pan Yongxiang;Ding Uxin;Zhu him;Yu jiangyuan;Yang Zhi(Key laboratory of Carcinogenesis and Translational Research(Ministry of Education),NMPA Key Laboratory for Research and Evaluation of Rddiopharmaceuticals,Beijing Quality Control and Improvement Center for Nuclear Medicine,Nuclear Medicine Department,Peking University Cancer Hospital&Institute,Beijing 100036,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科,国家药监局放射性药物研究与评价重点实验室,北京市核医学质量控制和改进中心,恶性肿瘤发病机制及转化研究教育部重点实验室,100036

出　　处：《中华放射医学与防护杂志》2021年第9期700-704,共5页Chinese Journal of Radiological Medicine and Protection

基　　金：国家自然科学基金(81871386)。

摘　　要：目的估算^(177)Lu-奥曲肽(^(177)Lu-DOTA-TATE)治疗神经内分泌肿瘤肾脏所受吸收剂量,评估辐射安全并指导治疗。方法^(177)Lu-DOTA-TATE治疗患者行单光子发射断层扫描(single photon emission computed tomography,SPECT)平面显像,勾画计数全身和肾脏区域并转换为活度,构建时间-活度单指数曲线方程,计算全身/肾脏的有效半衰期和累积活度,以MIRD(medical internal radiation dose)方法估算肾脏的吸收剂量。结果总共11名神经内分泌肿瘤患者进行了18例次^(177)Lu-DOTA-TATE药物治疗,全身和肾脏的有效半衰期分别为(20.0~99.8)和(38.2~75.2)h,平均有效半衰期分别为(57.3±21.4)和(53.1±2.5)h;肾脏所吸收的剂量为(0.25~1.48)mGy/MBq,平均吸收剂量为(0.90±0.31)mGy/MBq。患者单次疗程肾脏受到的吸收剂量最小1.8 Gy,最大9.6 Gy,多个疗程肾脏受到最大吸收剂量21.7 Gy。结论准确估算^(177)Lu-DOTA-TATE治疗神经内分泌肿瘤患者危险器官肾脏吸收剂量,结果低于耐受剂量限值,有望为患者的精准化治疗提供指导。Objective To estimate the renal absorbed dose in the treatment of neuroendocrine tumors using ^(177)Lu-DOTA-TATE and to assess the radiation safety and guide the treatment.Methods The dosimetric calculations of patients treated with ^(177)Lu-DOTA-TATE were carried out based on planar images of single photon emission computed tomography(SPECT).The regions of interest(ROIs)of the whole body and kidneys were delineated and converted into activity.Accordingly,the time-activity curves of the ROIs were obtained.The effective half-lives and cumulative activity of ROIs were calculated through the fitting of a single exponential equation of the ROIs.Then the absorbed doses were calculated based on the medical internal radiation dosimetry(MIRD)formalism.Results A total of 11 patients with neuroendocrine tumors received 18 cycles of treatments with ^(177)Lu-DOTA-TATE.The effective half-lives of ^(177)Lu-DOTA-TATE in the whole body and kidneys were 20.0-99.8 h and 38.2-75.2 h,respectively,with an average of(57.3±21.4)h and(53.1±12.5)h,respectively.The renal absorbed doses of ^(177)Lu-DTA-TATE were 0.25-1.48 mGy/MBq,with an average of(0.90±0.31)mGy/MBq.The minimum and maximum renal absorbed doses in a single treatment cycle were 1.8 Gy and 9.6 Gy,respectively,while the maximum renal absorbed dose in multiple treatment cycles was 21.7 Gy.Conclusions The renal absorbed doses in the treatment of neuroendocrine tumors using ^(177)Lu-DOTA-TATE were estimated.The result indicate that the renal absorbed doses were lower than the tolerable dose limits.This study is expected to guide the precise treatment of neuroendocrine tumors.

关 键 词：^(177)Lu 奥曲肽 神经内分泌肿瘤 吸收剂量 SPECT 

分 类 号：R739.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学]