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Targeted radionuclide therapy
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Targeted radionuclide therapy (TRT) seeks molecular and functional targets within patient
tumor sites. A
number of agents have been constructed and labeled with beta, alpha, and Auger emitters.
Radionuclide carriers spanning a broad range of sizes; e.g., antibodies, liposomes, and
constructs such as nanoparticles have been used in these studies. Uptake, in
percent-injected dose per gram of malignant tissue, is used to evaluate the specificity of the
targeting vehicle. Lymphoma (B-cell) has been the primary clinical application. Extension
to solid tumors
will require raising the macroscopic absorbed dose by several-fold over values found in present
technology. Methods that may effect such changes include multistep targeting, simultaneous
chemotherapy, and external sequestration of the agent. Toxicity has primarily involved red
marrow so that marrow replacement can also be used to enhance future TRT treatments.
Correlation of toxicities and treatment efficiency has been limited by relatively poor
estimates partly because of using standard (phantom) organ sizes. These associations
will be improved in the future by obtaining patient-specific organ size and activity data
with hybrid SPECT/CT and PET/CT scanners.
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