Individual dosimetry and monitoring response to treatment in tandem PRRT with [¹⁷⁷Lu/⁹⁰Y]-DOTA-TATE

• Autorzy: Kacperski, Krzysztof , Budzyńska, Anna , Kubik, Agata , Pastusiak, Patrycja , Chalewska, Wioletta , Lenda-Tracz, Wioletta , Borkowska, Anna , Walecka-Mazur, Agata , Szczodry, Artur , Braziewicz, Janusz , Kołodziej, Maciej , Kamiński, Grzegorz , Dedecjus, Marek , Długosińska, Joanna , Januszkiewicz-Caulier, Joanna , Hubalewska-Dydejczyk, Alicja , Opalińska, Marta , Kowalska, Aldona , Mikołajczak, Renata
• Języki publikacji: EN

Abstrakty

EN

Introduction: The Duonen project aims to test the efficacy of tandem PRRT therapy of neuroendocrine tumors with DOTA-TATE labeled with ¹⁷⁷Lu and ⁹⁰Y radionuclides compared to conventional mono-radionuclide therapy using ¹⁷⁷Lu with a fixed activity of 7.4 GBq. The paper presents the dosimetric procedure used and preliminary results obtained from the treatment of 40 patients and 113 cycles of therapy. Material and Methods: Dosimetry is performed using the QDose program based on 4 SPECT/CT scans and 5 blood samples taken for bone marrow dosimetry. Calculation of the dose to the kidneys is done by segmenting them on images, fitting the corresponding activity versus time (TAC) curves and calculating the dose using the Voxel-S method. The dose to the red marrow is calculated based on the IDAC2 model using the TAC curve for blood obtained from the measurements (self-dose) and the segmented organs from images (cross-dose). In addition, the time-integrated activity coefficients of activity in selected tumors or high uptake areas in four consecutive cycles of therapy were calculated for several patients as a measure of response to therapy. Results: Large variability of individual doses to kidneys is observed. The average specific dose for ¹⁷⁷Lu was equal to 0.76 Gy/GBq, SD = 0.29 Gy/GBq, and for ⁹⁰Y: 3.26 Gy/GBq, SD = 1.26 Gy/GBq. With the standard activity equal to 7.4 GBq in the first cycle, the activity in the next cycle could be increased by > 10% in 60% of cases and had to be decreased in 16% of cases. Conclusion: Individual dosimetry is an important part of PRRT, leading to significant dose modifications in subsequent cycles in more than 80% of the cases studied.

Słowa kluczowe

EN

radionuclide therapy; PRRT; individual dosimetry; tumor response

• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2024
• Tom: Vol. 30, Iss. 4
• Strony: 294--299
• Opis fizyczny: Bibliogr. 13 poz., rys., tab.

Twórcy

autor

Kacperski, Krzysztof

• Particle Acceleration Physics and Technology Division, National Centre for Nuclear Research, Otwock-Świerk, Poland,
• Department of Nuclear Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland

autor

Budzyńska, Anna

• Department of Nuclear Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland

autor

Kubik, Agata

• Department of Nuclear Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland

autor

Pastusiak, Patrycja

• Department of Nuclear Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland

autor

Chalewska, Wioletta

• Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

autor

Lenda-Tracz, Wioletta

• Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland

autor

Borkowska, Anna

• Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland

autor

Walecka-Mazur, Agata

• Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland

autor

Szczodry, Artur

• Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland

autor

Braziewicz, Janusz

• Department of Nuclear Medicine, Holycross Cancer Center, Kielce, Poland

autor

Kołodziej, Maciej

• Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine – National Research Institute, Warsaw, Poland

autor

Kamiński, Grzegorz

• Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine – National Research Institute, Warsaw, Poland

autor

Dedecjus, Marek

• Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

autor

Długosińska, Joanna

• Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

autor

Januszkiewicz-Caulier, Joanna

• Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

autor

Hubalewska-Dydejczyk, Alicja

• Chair and Department of Endocrinology, Jagiellonian University Medical College, Cracow, Poland

autor

Opalińska, Marta

• Chair and Department of Endocrinology, Jagiellonian University Medical College, Cracow, Poland

autor

Kowalska, Aldona

• Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland

autor

Mikołajczak, Renata

• Radioisotope Centre POLATOM, National Centre for Nuclear Research, Otwock-Świerk, Poland

Bibliografia

• 1. Fani M, Maecke HR, Okarvi SM. Radiolabeled Peptides: Valuable Tools for the Detection and Treatment of Cancer. Theranostics. 2012;2(5):481-501. https://doi.org/10.7150/thno.4024
• 2. Loharkar S, Basu S. Peptide receptor radionuclide therapy in neuroendocrine neoplasms and related tumors: from fundamentals to personalization and the newer experimental approaches. Expert Review of Precision Medicine and Drug Development. 2023;8(1):1-32. https://doi.org/10.1080/23808993.2023.2211090
• 3. Gabriel M, Nilica B, Kaiser B, Virgolini IJ. Twelve-Year Follow-up After Peptide Receptor Radionuclide Therapy. J Nucl Med. 2018;60(4):524-529. https://doi.org/10.2967/jnumed.118.215376
• 4. Sandström M, Garske-Román U, Johansson S, Granberg D, Sundin A, Freedman N. Kidney dosimetry during 177Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance. Acta Oncologica. 2017;57(4):516-521. https://doi.org/10.1080/0284186X.2017.1378431
• 5. Marin G, Vanderlinden B, Karfis I, et al. A dosimetry procedure for organs-at-risk in 177Lu peptide receptor radionuclide therapy of patients with neuroendocrine tumours. Physica Medica. 2018;56:41-49. https://doi.org/10.1016/j.ejmp.2018.11.001
• 6. Santoro L, Mora-Ramirez E, Trauchessec D, et al. Implementation of patient dosimetry in the clinical practice after targeted radiotherapy using [177Lu-[DOTA0, Tyr3]-octreotate. EJNMMI Res. 2018;8(1). https://doi.org/10.1186/s13550-018-0459-4
• 7. Zaknun JJ, Bodei L, Mueller-Brand J, et al. The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2013;40(5):800-816. https://doi.org/10.1007/s00259-012-2330-6
• 8. Haug AR. PRRT of neuroendocrine tumors: individualized dosimetry or fixed dose scheme? EJNMMI Res. 2020;10(1). https://doi.org/10.1186/s13550-020-00623-3
• 9. Opalińska M, Kamiński G, Dedecjus M, et al. DUONEN multicenter study - personalized PRRT treatment with 177Lu- or 177Lu/90Y-DOTA-TATE in patients with neuroendocrine tumors based on individual dosimetry. Endocrine Abstracts. 2023;90:P440. https://doi.org/10.1530/endoabs.90.P440
• 10. Siegel JA, Thomas SR, Stubbs JB, et al. MIRD pamphlet no. 16: techniques for quantitative radiopharmaceutical biodistribution data acquisition and analysis for use in human radiation dose estimates. Journal of Nuclear Medicine. 1999;40(2):37S-61S.
• 11. Hindorf C, Glatting G, Chiesa C, Lindén O, Flux G. EANM Dosimetry Committee guidelines for bone marrow and whole-body dosimetry. Eur J Nucl Med Mol Imaging. 2010;37(6):1238-1250. https://doi.org/10.1007/s00259-010-1422-4
• 12. Hwang SH, Jung M, Jeong YH, et al. Prognostic value of metabolic tumor volume and total lesion glycolysis on preoperative 18F-FDG PET/CT in patients with localized primary gastrointestinal stromal tumors. Cancer Metab. 2021;9(1). https://doi.org/10.1186/s40170-021-00244-x
• 13. Chicheportiche A, Ben-Haim S, Grozinsky-Glasberg S, et al. Dosimetry after peptide receptor radionuclide therapy: impact of reduced number of post-treatment studies on absorbed dose calculation and on patient management. EJNMMI Phys. 2020;7(1). https://doi.org/10.1186/s40658-020-0273-8

Identyfikatory

DOI

10.2478/pjmpe-2024-0037