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A Critical Review of Alpha Radionuclide Therapy—How to Deal with Recoiling Daughters?

机译：阿尔法放射性核素疗法的批判性评论-如何应对退缩的女儿？

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This review presents an overview of the successes and challenges currently faced in alpha radionuclide therapy. Alpha particles have an advantage in killing tumour cells as compared to beta or gamma radiation due to their short penetration depth and high linear energy transfer (LET). Touching briefly on the clinical successes of radionuclides emitting only one alpha particle, the main focus of this article lies on those alpha-emitting radionuclides with multiple alpha-emitting daughters in their decay chain. While having the advantage of longer half-lives, the recoiled daughters of radionuclides like 224Ra (radium), 223Ra, and 225Ac (actinium) can do significant damage to healthy tissue when not retained at the tumour site. Three different approaches to deal with this problem are discussed: encapsulation in a nano-carrier, fast uptake of the alpha emitting radionuclides in tumour cells, and local administration. Each approach has been shown to have its advantages and disadvantages, but when larger activities need to be used clinically, nano-carriers appear to be the most promising solution for reducing toxic effects, provided there is no accumulation in healthy tissue.
机译：本文对α放射性核素治疗目前面临的成功和挑战进行了概述。与β或γ辐射相比，α粒子具有杀死肿瘤细胞的优势，这是因为它们的穿透深度短且线性能量转移（LET）高。简要介绍仅发射一个α粒子的放射性核素的临床成功之处，本文的主要重点在于那些在衰变链中具有多个α发射子体的α发射放射性核素。虽然具有更长的半衰期优势，但放射性核素的后坐子如 224 Ra（radium）， 223 Ra和 225 Ac（如果不保留在肿瘤部位，则可能对健康组织造成重大损害。讨论了解决该问题的三种不同方法：将其封装在纳米载体中，在肿瘤细胞中快速吸收发射α的放射性核素以及局部给药。每种方法都有其优点和缺点，但是当需要在临床上使用较大的活性时，只要在健康组织中没有积累，纳米载体似乎是减少毒性作用的最有希望的解决方案。

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