| 孙莹莹,左迪,郑菲,等.177Lu-PRRT治疗神经母细胞瘤对看护者和公众的外照射辐射剂量研究[J].中华放射医学与防护杂志,2025,45(3):216-222.Sun Yingying,Zuo Di,Zheng Fei,et al.External dose to caregivers and the public during 177Lu-PRRT for neuroblastoma[J].Chin J Radiol Med Prot,2025,45(3):216-222 |
| 177Lu-PRRT治疗神经母细胞瘤对看护者和公众的外照射辐射剂量研究 |
| External dose to caregivers and the public during 177Lu-PRRT for neuroblastoma |
| 投稿时间：2024-04-29 |
| DOI：10.3760/cma.j.cn112271-20240429-00162 |
| 中文关键词: 神经母细胞瘤 辐射剂量 肽受体放射性核素治疗 接触限值 177Lu |
| 英文关键词:Neuroblastoma Radiation dosage Peptide receptor radionuclide therapy Exposure limits 177Lu |
| 基金项目:国家自然科学基金(82373424) |
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| 中文摘要: |
| 目的 估算儿童神经母细胞瘤患者接受177Lu-肽受体放射性核素治疗(PRRT)对看护者和公众的辐射剂量,并确定接触限制的时间,为相关的辐射防护措施提供参考依据。方法 回顾性收集2023年6月至7月在山东第一医科大学附属肿瘤医院核医学科接受177Lu-1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸-D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽(DOTATATE)治疗的18例儿童神经母细胞瘤患者资料。给药后1、4、24、48和96 h,分别于距患者0、0.1、0.5、1和2 m处使用X、γ辐射剂量仪测量患者空气吸收剂量率。利用HERMES软件绘制全身感兴趣区,随后利用双指数函数模型进行曲线回归拟合,结合假设社交接触时间,估算看护者和公众与患者接触而接受的有效剂量。此外,使用MIM软件勾画全身感兴趣体积得到全身病灶总体积,使用皮尔森或斯皮尔曼相关系数分析空气吸收剂量率与临床指标及病灶总体积的相关性。结果 177Lu-DOTATATE给药剂量均值为(4 353.42±1 451.51)MBq。患者均于177Lu-DOTATATE给药后24 h出院。患者出院时体内总药量清除为(76.70±3.99)%。出院时距患者0.1、1和2 m处的空气吸收剂量率分别为(32.74±6.98)、3.68(3.01,4.70)和(1.22±0.51)μSv/h。出院后,2~5岁和5~13岁的儿童对看护者的辐射剂量分别为(2.47±1.80)和(0.88±0.47)mSv。患者与家庭成员夜间睡眠接触限制期为2 d,与其他儿童接触限制期为1 d。出院当天,患者应将乘坐公共交通工具的时间限制在4 h内,不需要限制私人交通。结论 为确保有效剂量控制在现行规定的安全范围内,有必要对患者家庭成员和公众进行接触限制。实施预防措施后,177Lu-DOTATATE是一种安全的放射性核素治疗方案。 |
| 英文摘要: |
| Objective To estimate the radiation dose to caregivers and the public from 177Lu- peptide receptor radionuclide therapy (PRRT) for pediatric neuroblastoma patients and determine the duration of contact restrictions, in order to provide a reference for relevant radiation protection measures. Methods A retrospective study was conducted by collecting data from 18 pediatric neuroblastoma patients, aged between 3 and 13 (6.72±2.72), who received 177Lu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) treatment at the Nuclear Medicine Department of Shandong Cancer Hospital from June 2023 to July 2023. Absorbed dose rate in air at 0, 0.1, 0.5, 1 and 2 m from the patients was measured using a radiation-survey at 1, 4, 24, 48 and 96 h after administration. The whole-body region of interest was delined using HERMES software. Subsequently, curve regression fitting was performed using a biexponential function model. By incorporating hypothesized social contact durations, the effective doses received by family members and the public in contact with patients were estimated. Additionally, MIM software was used to outline the whole-body VOI to obtain the total volume of lesions, and the Pearson or Spearman correlation coefficient was employed to analyze the relationship between the absorbed dose rate in air and clinical indicators as well as the total volume of lesions. Results The 177Lu-DOTATATE administration dose was (4 353.42±1 451.51) MBq. All patients were discharged from hospital 24 h after 177Lu-DOTATATE administration. At the time of discharge, patients had excreted (76.70±3.99)% of the administered activity, and the absorbed dose rate in air at 0.1, 1 and 2 m from the patients were (32.74±6.98), 3.68(3.01, 4.70) and (1.22±0.51) μSv/h, respectively. After being discharged, the radiation doses to caregivers from children aged 2-5 years and 5-13 years were (2.47±1.80) mSv and (0.88±0.47) mSv, respectively. The contact restriction duration was 2 d for nighttime sleeping with family members and 1 d for contact with other children. On the day of discharge, patients should limit their time on public transportation within 4 h and do not need to restrict private transportation. Conclusions To ensure the effective dose kept within the safety limits stipulated by current regulations, it is necessary to implement contact restrictions for patients’ family members and the public. After implementing preventive measures, 177Lu-DOTATATE treatment is a safe radionuclide therapeutic option. |
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