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首页> 外文期刊>The Journal of Nuclear Medicine >Therapeutic potential of 90Y- and 131I-labeled anti-CD20 monoclonal antibody in treating non-Hodgkin's lymphoma with pulmonary involvement: a Monte Carlo-based dosimetric analysis.
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Therapeutic potential of 90Y- and 131I-labeled anti-CD20 monoclonal antibody in treating non-Hodgkin's lymphoma with pulmonary involvement: a Monte Carlo-based dosimetric analysis.

机译：90Y和131I标记的抗CD20单克隆抗体在治疗肺部非霍奇金淋巴瘤中的治疗潜力：基于蒙特卡洛的剂量分析。

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摘要

Pulmonary involvement is common in patients with non-Hodgkin's lymphoma (NHL). (90)Y- and (131)I-anti-CD20 antibodies (ibritumomab tiuxetan and tositumomab, respectively) have been approved for the treatment of refractory low-grade follicular NHL. In this work, we used Monte Carlo-based dosimetry to compare the potential of (90)Y and (131)I, based purely on their emission properties, in targeted therapy for NHL lung metastases of various nodule sizes and tumor burdens. METHODS: Lung metastases were simulated as spheres, with radii ranging from 0.2 to 5.0 cm, which were randomly distributed in a voxelized adult male lung phantom. Total tumor burden was varied from 0.2 to 1,641 g. Tumor uptake and retention kinetics of the 2 radionuclides were assumed equivalent; a uniform distribution of activity within tumors was assumed. Absorbed dose to tumors and lung parenchyma per unit activity in lung tumors was calculated by a Monte Carlo-based system using the MCNP4B package. Therapeutic efficacy was defined asthe ratio of mean absorbed dose in the tumor to that in normal lung. Dosimetric analysis was also performed for a lung-surface distribution of tumor nodules mimicking pleural metastatic disease. RESULTS: The therapeutic efficacy of both (90)Y and (131)I declined with increasing tumor burden. In treating tumors with radii less than 2.0 cm, (131)I targeting was more efficacious than (90)Y targeting. (90)Y yielded a broader distribution of tumor absorbed doses, with the minimum 54.1% lower than the average dose; for (131)I, the minimum absorbed dose was 33.3% lower than the average. The absorbed dose to normal lungs was reduced when the tumors were distributed on the lung surface. For surface tumors, the reductions in normal-lung absorbed dose were greater for (90)Y than for (131)I, but (131)I continued to provide a greater therapeutic ratio across different tumor burdens and sizes. CONCLUSION: Monte Carlo-based dosimetry was performed to compare the therapeutic potential of (90)Y and (131)I targeting of lung metastases in NHL patients. (131)I provided a therapeutic advantage over (90)Y, especially in tumors with radii less than 2.0 cm and at lower tumor burdens. For both (90)Y- and (131)I-labeled antibodies, treatment is more efficacious when applied to metastatic NHL cases with lower tumor burdens. (131)I has advantages over (90)Y in treating smaller lung metastases.
机译：肺部受累在非霍奇金淋巴瘤（NHL）患者中很常见。 （90）Y-和（131）I-抗CD20抗体（分别为ibritumomab tiuxetan和tositumomab）已被批准用于治疗难治性低级滤泡性NHL。在这项工作中，我们使用基于Monte Carlo的剂量测定法，仅基于它们的发射特性，比较了（90）Y和（131）I在各种结节大小和肿瘤负荷的NHL肺转移的靶向治疗中的潜力。方法：将肺转移瘤模拟为球体，半径范围为0.2至5.0 cm，随机分布在体素化的成年男性肺部幻影中。总肿瘤负荷在0.2至1,641g之间变化。假定这两种放射性核素的肿瘤吸收和保留动力学相同。假定肿瘤内活性的均匀分布。使用MCNP4B软件包，基于Monte Carlo的系统计算出肺肿瘤中每单位活性的肿瘤和肺实质的吸收剂量。治疗功效定义为肿瘤中平均吸收剂量与正常肺中平均吸收剂量之比。还进行了剂量学分析，以模拟模仿胸膜转移性疾病的肿瘤结节在肺表面的分布。结果：（90）Y和（131）I的治疗效果均随着肿瘤负荷的增加而下降。在治疗半径小于2.0 cm的肿瘤时，（131）I靶向比（90）Y靶向更有效。 （90）Y产生更广泛的肿瘤吸收剂量分布，最小剂量比平均剂量低54.1％;对于（131）I，最小吸收剂量比平均剂量低33.3％。当肿瘤分布在肺表面时，减少了对正常肺的吸收剂量。对于表面肿瘤，（90）Y比（131）I的正常肺吸收剂量减少更大，但是（131）I继续在不同的肿瘤负荷和大小上提供更大的治疗率。结论：进行了基于Monte Carlo的剂量测定，以比较（90）Y和（131）I靶向治疗NHL患者肺转移的潜力。 （131）I提供的治疗优势优于（90）Y，尤其是在半径小于2.0 cm且肿瘤负荷较低的肿瘤中。对于（90）Y标记的抗体和（131）I标记的抗体，当应用于肿瘤负荷较低的转移性NHL病例时，治疗更为有效。 （131）I比（90）Y在治疗较小的肺转移方面具有优势。

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