^(177)Lu-PSMA-617治疗前列腺癌对公众人群外照射辐射剂量研究  

External exposure dose of ^(177)Lu-PSMA-617 to the public in the treatment of prostate cancer

作　　者：邓颖 何丽萌 孙占良 刘林 陈跃 张伟 Deng Ying;He Limeng;Sun Zhanliang;Liu Lin;Chen Yue;Zhang Wei(Department of Nuclear Medicine,the Affiliated Hospital of Southwest Medical University,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province,Academician(Expert)Workstation of Sichuan Province,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院核医学科、核医学与分子影像四川省重点实验室、四川省院士(专家)工作站,泸州646000

出　　处：《中华核医学与分子影像杂志》2022年第9期529-533,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：四川省中央引导地方科技发展专项(2020ZYD101)。

摘　　要：目的估算前列腺癌患者^(177)Lu-前列腺特异膜抗原(PSMA)-617治疗后对公众辐射剂量(RD)水平,为^(177)Lu-PSMA-617治疗辐射防护措施的制定提供参考。方法回顾性分析2020年7月至2021年1月间于西南医科大学附属医院接受^(177)Lu-PSMA-617治疗的10例前列腺癌患者[年龄(71.1±5.9)岁],按照不同的^(177)Lu-PSMA-617推注剂量,分为低剂量组(5.55~6.29 GBq)及高剂量组(6.70~8.94 GBq),在静脉推注药物后的5、30 min和1、2、4、24、48、72、96、144 h,分别在距患者0.3、1.0、2.0 m处,利用辐射监测剂量仪测量患者的外辐射初始剂量当量率(DR)。通过HERMES软件对ROI统计量进行分析,通过双指数函数模型进行曲线回归拟合得到相应方程。依据美国国家辐射防护和测量委员会(NCRP)提出的人类社会活动模式,估算^(177)Lu-PSMA-617治疗后患者不同时间出院对公众人群的RD。结果患者均在完成治疗后72 h出院,距患者0.3、1.0和2.0 m处的初始DR分别为(12.6±3.3)、(4.7±1.2)和(1.6±0.4)μSv/h;同床共睡的伴侣、日间接触的家属和同事的RD分别为(999±253)、(121±29)和(160±39)μSv。患者若在完成治疗后48 h出院,即可将成年家属的RD控制在≤5 mSv,同事及儿童的RD控制在≤1 mSv。从^(177)Lu-PSMA-617给药后开始,患者与伴侣分睡限制期以及与同事接触的限制期均为2 d,日间儿童接触的限制期为2 d(高剂量组)或1 d(低剂量组);给药后第1~4天,患者需限制公共交通工具乘坐时间,从第5天开始乘坐公共交通工具则没有时间限制。结论根据目前对公众的RD限制,如果采取了良好的安全预防措施,^(177)Lu-PSMA-617治疗前列腺癌是一种较为安全的治疗方式。Objective To estimate the radiation dose(RD)to the public from patients undergoing ^(177)Lu-prostate specific membrane antigen(PSMA)-617 therapy,and provide reference for the formulation of radiation protection measures.Methods From July 2020 to January 2021,10 patients with prostate cancer(age(71.1±5.9)years)who received ^(177)Lu-PSMA-617 therapy in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed.According to the different doses of ^(177)Lu-PSMA-617,the patients were divided into the low-dose(5.55-6.29 GBq)group and high-dose(6.70-8.94 GBq)group.Respectively at 5,30 min and 1,2,4,24,48,72,96,144 h after intravenous injection of ^(177)Lu-PSMA-617,whole-body initial dose-equivalent rate(DR)was measured with a radiation-survey meter at 0.3,1.0 and 2.0 m from the patients.The statistics of ROI were analyzed by HERMES,and the corresponding equations were obtained by fitting the curve regression with double exponential function model.On the basis of human social contact model proposed by the National Council on Radiation Protection and Measurements(NCRP),the RD to the public from the patient discharged from the hospital at different times after completing the ^(177)Lu-PSMA-617 injection was estimated.Results All patients were discharged from the hospital at 72 h after treatment.The initial DR at 0.3,1.0 and 2.0 m were(12.6±3.3),(4.7±1.2)and(1.6±0.4)μSv/h,respectively,and the RD to the co-sleeping partner,family members and colleagues who were in contact during the day were(999±253),(121±29)and(160±39)μSv,respectively.If the patients were discharged at 48 h after treatment,the RD to the adult family members could be controlled≤5 mSv,and the RD to colleagues and children could be controlled≤1 mSv.Starting from the injection of ^(177)Lu-PSMA-617,the restriction duration for co-sleeping partner and colleagues were both 2 d and the restriction duration for children were 2 d(high-dose group)or 1 d(low-dose group).The patients needed to limit the time for public transportati

关 键 词：前列腺肿瘤 辐射剂量 前列腺特异膜抗原 二肽类 镥 

分 类 号：R737.25[医药卫生—肿瘤]