Seminars in Nuclear Medicine
Volume 38, Issue 5 , Pages 347-357 , September 2008

Risks to Normal Tissues From Radionuclide Therapy

  • Ruby Meredith, MD, PhD

      Affiliations

    • University of Alabama at Birmingham, Birmingham, AL.
    • Corresponding Author InformationAddress reprint requests to Ruby Meredith, MD, PhD, Department of Radiation Oncology, University of Alabama at Birmingham, 1824 6th Ave South, Birmingham, AL 35249.
    • ,
  • Barry Wessels, PhD

      Affiliations

    • Case Western Reserve University, Cleveland, OH.
    • ,
  • Susan Knox, MD, PhD

      Affiliations

    • Stanford University, Stanford, CA.

References 

  1. Meredith R. Clinical trial design and scoring of radionuclide therapy endpoints: Normal organ toxicity and tumor response. Cancer Biother Radiopharm. 2002;17:83–99
  2. Knox SJ, Levy R, Miller RA, et al. Determinants of the antitumor effect of radiolabeled monoclonal antibodies. Cancer Res. 1990;50:4935–4940
  3. Verwijnen S, Capello A, Bernard B, et al. Low-dose-rate irradiation by 131I versus high-dose-rate external-beam irradiation in the rat pancreatic tumor cell line CA20948. Cancer Biother Radiopharm. 2004;19:285–292
  4. Neti PV, Howell RW. Log normal distribution of cellular uptake of radioactivity: Implications for biologic responses to radiopharmaceuticals. J Nucl Med. 2006;47:1049–1058
  5. Carlsson J, Eriksson V, Stenerlow B, et al. Requirements regarding dose rate and exposure time for killing of tumour cells in beta particle radionuclide therapy. Eur J Nucl Med Mol Imaging. 2006;33:1185–1195
  6. Bodei L, Cremonesi M, Grana C, et al. Receptor radionuclide therapy with 90Y-[DOTA]0-Tyr3-octreotide (90Y-DOTATOC) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2004;31:1038–1046
  7. Abrams PG, Fritzberg AR. Radioimmunotherapy of Cancer. New York, NY: Marcel Dekker, Inc; 2000;
  8. Hagenbeek A. Radioimmunotherapy for NHL: Experience of 90Y-ibritumomab tiuxetan in clinical practice. Leuk Lymphoma. 2003;44(suppl 4):S37–S47
  9. Blumenthal RD, Lew W, Juweid M, et al. Plasma FLT3-L levels predict bone marrow recovery from myelosuppressive therapy. Cancer. 2000;88:333–343
  10. Martin S, Kronenwett R, Vandenbulcke K, et al. Targeted alpha radiation and gamma rays induce significantly different molecular responses in human leukemic lymphocytes as revealed by gene expression profiling. J Nucl Med. 2005;46(suppl 2):192
  11. Sgouros G, Knox SJ, Joiner MC, et al. MIRD continuing education: Bystander and low dose-rate effects: are these relevant to radionuclide therapy?. J Nucl Med. 2007;48:1683–1691
  12. Fowler JF, Stern BE. Dose-rate effects: Some theoretical and practical considerations. Br J Radiol. 1960;33:389–395
  13. Barendsen GW. Dose fractionation, dose rate and iso-effect relationships for normal tissue responses. Int J Radiat Oncol Biol Phys. 1982;8:1981–1997
  14. Thames HD. An ‘incomplete-repair’ model for survival after fractionated and continuous irradiations. Int J Radiat Biol Relat Stud Phys Chem Med. 1985;47:319–339
  15. Fowler JF. Radiobiological aspects of low dose rates in radioimmunotherapy. Int J Radiat Oncol Biol Phys. 1990;18:1261–1269
  16. Langmuir VK, Fowler JF, Knox SJ, et al. Radiobiology of radiolabeled antibody therapy as applied to tumor dosimetry. Med Phys. 1993;20:601–610
  17. Dale RG. Dose-rate effects in targeted radiotherapy. Phys Med Biol. 1996;41:1871–1884
  18. O'Donoghue JA. Optimal therapeutic strategies for radioimmunotherapy. Recent Results Cancer Res. 1996;141:77–99
  19. Howell RW, Goddu SM, Rao DV. Proliferation and the advantage of longer-lived radionuclides in radioimmunotherapy. Med Phys. 1998;25:37–42
  20. Yorke ED, Wessels BW, Bradley EW. Absorbed dose averages and dose heterogeneities in Radioimmunotherapy. Antibody Immunoconjugates and Radiopharmaceuticals. 1991;4:623–629
  21. Thames H, Hendry JH. Fractionation in Radiotherapy. London: Taylor and Francis; 1987;
  22. Kassis AI, Adelstein SJ. Radiobiologic principles in radionuclide therapy. J Nucl Med. 2005;1(suppl 46):4S–12S
  23. Sgouros G. Dosimetry of internal emitters. J Nucl Med. 2005;46(suppl 1):18S–27S
  24. Dale R. Use of the linear-quadratic radiobiological model for quantifying kidney response in targeted radiotherapy. Cancer Biother Radiopharm. 2004;19:363–370
  25. Brenner DJ, Hlatky LR, Hahnfeldt PJ, et al. The linear-quadratic model and most other common radiobiological models result in similar predictions of time-dose relationships. Radiat Res. 1998;150:83–91
  26. Dale RG. The application of the linear-quadratic dose-effect equation to fractionated and protracted radiotherapy. Br J Radiol. 1985;58:515–528
  27. Guerrero M, Li XA. Extending the linear-quadratic model for large fraction doses pertinent to stereotactic radiotherapy. Phys Med Biol. 2004;49:4825–4835
  28. Song DY, Kavanagh BD, Benedict SH, et al. Stereotactic body radiation therapy (Rationale, techniques, applications, and optimization). Oncology (Williston Park). 2004;18:1419–1430discussion 1430, 1432:1435-1416
  29. Ruben JD, Dally M, Bailey M, et al. Cerebral radiation necrosis: incidence, outcomes, and risk factors with emphasis on radiation parameters and chemotherapy. Int J Radiat Oncol Biol Phys. 2006;65:499–508
  30. Brill AB, Stabin M, Bouville A, et al. Normal organ radiation dosimetry and associated uncertainties in nuclear medicine, with emphasis on iodine-131. Radiat Res. 2006;166:128–140
  31. Mothersill C, Seymour C. Low-dose radiation effects: experimental hematology and the changing paradigm. Exp Hematol. 2003;31:437–445
  32. Mothersill C, Seymour C. Radiation-induced bystander effects, carcinogenesis and models. Oncogene. 2003;22:7028–7033
  33. Bouchard VJ, Rouleau M, Poirier GG. PARP-1, a determinant of cell survival in response to DNA damage. Exp Hematol. 2003;31:446–454
  34. Albanese J, Dainiak N. Modulation of intercellular communication mediated at the cell surface and on extracellular, plasma membrane-derived vesicles by ionizing radiation. Exp Hematol. 2003;31:455–464
  35. Boyd M, Ross SC, Dorrens J, et al. Radiation-induced biologic bystander effect elicited in vitro by targeted radiopharmaceuticals labeled with alpha-, beta-, and auger electron-emitting radionuclides. J Nucl Med. 2006;47:1007–1015
  36. Davidson SE, Trotti A, Ataman OU, et al. Improving the capture of adverse event data in clinical trials: The role of the International Atomic Energy Agency. Int J Radiat Oncol Biol Phys. 2007;69:1218–1221
  37. Trotti A, Colevas AD, Setser A, et al. CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol. 2003;13:176–181
  38. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341–1346
  39. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–323
  40. Tronko MD, Howe GR, Bogdanova TI, et al. A cohort study of thyroid cancer and other thyroid diseases after the chornobyl accident: thyroid cancer in Ukraine detected during first screening. J Natl Cancer Inst. 2006;98:897–903
  41. Kry SF, Salehpour M, Followill DS, et al. The calculated risk of fatal secondary malignancies from intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2005;62:1195–1203
  42. Rubino C, Adjadj E, Doyon F, et al. Radiation exposure and familial aggregation of cancers as risk factors for colorectal cancer after radioiodine treatment for thyroid carcinoma. Int J Radiat Oncol Biol Phys. 2005;62:1084–1089
  43. Bal C, Kumar A, Tripathi M, et al. High-dose radioiodine treatment for differentiated thyroid carcinoma is not associated with change in female fertility or any genetic risk to the offspring. Int J Radiat Oncol Biol Phys. 2005;63:449–455
  44. Subramanian S, Goldstein DP, Parlea L, et al. Second primary malignancy risk in thyroid cancer survivors: A systematic review and meta-analysis. Thyroid. 2007;17:1277–1288
  45. Brown JR, Yeckes H, Friedberg JW, et al. Increasing incidence of late second malignancies after conditioning with cyclophosphamide and total-body irradiation and autologous bone marrow transplantation for non-Hodgkin's lymphoma. J Clin Oncol. 2005;23:2208–2214
  46. Kaminski MS, Zelenetz AD, Press OW, et al. Pivotal study of iodine I 131 tositumomab for chemotherapy-refractory low-grade or transformed low-grade B-cell non-Hodgkin's lymphomas. J Clin Oncol. 2001;19:3918–3928
  47. Bennett JM, Kaminski MS, Leonard JP, et al. Assessment of treatment-related myelodysplastic syndromes and acute myeloid leukemia in patients with non-Hodgkin lymphoma treated with tositumomab and iodine I131 tositumomab. Blood. 2005;105:4576–4582
  48. Rubin P, Casarett GW. A direction for clinical radiation pathology: A tolerance dose. In:  Vaeth JM editors. Frontiers of Radiation Oncology and Therapy. Vol. 6:Baltimore, MD: University Park Press; 1972;p. 1–16
  49. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109–122
  50. Sarfaraz M, Kennedy AS, Lodge MA, et al. Radiation absorbed dose distribution in a patient treated with yttrium-90 microspheres for hepatocellular carcinoma. Med Phys. 2004;31:2449–2453
  51. Lyman JT. Complication probability as assessed from dose-volume histograms. Radiat Res Suppl. 1985;8:S13–S19
  52. Lyman JT, Wolbarst AB. Optimization of radiation therapy, IV: A dose-volume histogram reduction algorithm. Int J Radiat Oncol Biol Phys. 1989;17:433–436
  53. Milano MT, Constine LS, Okunieff P. Normal tissue tolerance dose metrics for radiation therapy of major organs. Semin Radiat Oncol. 2007;17:131–140
  54. Mundt A, Roeske J. Intensity Modulated Radiation Therapy: A Clinical Perspective. Hamilton, ON: BC Decker, Inc; 2005;
  55. Dawson LA, Biersack M, Lockwood G, et al. Use of principal component analysis to evaluate the partial organ tolerance of normal tissues to radiation. Int J Radiat Oncol Biol Phys. 2005;62:829–837
  56. Glatstein E. Personal thoughts on normal tissue tolerance, or, what the textbooks don't tell you. Int J Radiat Oncol Biol Phys. 2001;51:1185–1189
  57. Cheng JC, Liu HS, Wu JK, et al. Inclusion of biological factors in parallel-architecture normal-tissue complication probability model for radiation-induced liver disease. Int J Radiat Oncol Biol Phys. 2005;62:1150–1156
  58. Zhou SD, Yan H, Zeng J, et al. Marks Identification of predictors of RT-induced toxicity with the Random Forests Technique. Int J Radiat Oncol Biol Phys. 2006;66:519s
  59. Bodey RK, Evans PM, Flux GD. Application of the linear-quadratic model to combined modality radiotherapy. Int J Radiat Oncol Biol Phys. 2004;59:228–241
  60. Yorke ED, Jackson A, Fox RA, et al. Can current models explain the lack of liver complications in Y-90 microsphere therapy?. Clin Cancer Res. 1999;5:3024s–3030s
  61. Andrews JC, Walker SC, Ackermann RJ, et al. Hepatic radioembolization with yttrium-90 containing glass microspheres: Preliminary results and clinical follow-up. J Nucl Med. 1994;35:1637–1644
  62. Tempero M, Leichner P, Baranowska-Kortylewicz J, et al. High-dose therapy with 90Yttrium-labeled monoclonal antibody CC49: A phase I trial. Clin Cancer Res. 2000;6:3095–3102
  63. Kennedy AS, Nutting C, Coldwell D, et al. Pathologic response and microdosimetry of (90)Y microspheres in man: Review of four explanted whole livers. Int J Radiat Oncol Biol Phys. 2004;60:1552–1563
  64. Order SE, Siegel JA, Principato R, et al. Selective tumor irradiation by infusional brachytherapy in nonresectable pancreatic cancer: A phase I study. Int J Radiat Oncol Biol Phys. 1996;36:1117–1126
  65. Wessels BW, Yorke ED, Bradley EW. Dosimetry of heterogeneous uptake of radiolabeled antibody for radioimmunotherapy. Front Radiat Ther Oncol. 1990;24:104–108discussion 121-102
  66. Schefter TE, Kavanagh BD, Timmerman RD, et al. A phase I trial of stereotactic body radiation therapy (SBRT) for liver metastases. Int J Radiat Oncol Biol Phys. 2005;62:1371–1378
  67. Neff R, Abdel-Misih R, Khatri J, et al. The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors. Cancer Invest. 2008;26:173–177
  68. Reardon DA, Akabani G, Coleman RE, et al. Phase II trial of murine (131)I-labeled antitenascin monoclonal antibody 81C6 administered into surgically created resection cavities of patients with newly diagnosed malignant gliomas. J Clin Oncol. 2002;20:1389–1397
  69. Riva P, Franceschi G, Frattarelli M, et al. Loco-regional radioimmunotherapy of high-grade malignant gliomas using specific monoclonal antibodies labeled with 90Y: A phase I study. Clin Cancer Res. 1999;5:3275s–3280s
  70. Akabani G, Reardon DA, Coleman RE, et al. A phase II study of 131I-labeled anti-tenascin 81C6 murine monoclonal antibody in newly diagnosed patients with malignant gliomas: Dosimetry and radiographic analysis. In: Supplement 2 edition. Supplement to The Journal of Nuclear Medicine-Abstract Book. Vol. 46:Reston, VA: Society of Nuclear Medicine, Inc; 2005;p. 446P
  71. Zalutsky MR, Reardon DA, Akabani G, et al. Clinical experience with {alpha}-particle emitting 211At: Treatment of recurrent brain tumor patients with 211At-labeled chimeric antitenascin monoclonal antibody 81C6. J Nucl Med. 2008;49:30–38
  72. Shaw E, Scott C, Souhami L, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: Final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys. 2000;47:291–298
  73. Korytko T, Radivoyevitch T, Colussi V, et al. 12 Gy gamma knife radiosurgical volume is a predictor for radiation necrosis in non-AVM intracranial tumors. Int J Radiat Oncol Biol Phys. 2006;64:419–424
  74. Gutierrez AN, Westerly DC, Tome WA, et al. Whole brain radiotherapy with hippocampal avoidance and simultaneously integrated brain metastases boost: A planning study. Int J Radiat Oncol Biol Phys. 2007;69:589–597
  75. Flickinger JCKD, Lunsford LD. Dose and diameter relationships for facial, trigeminal and acoustic neuropathies following acoustic neuroma radiosurgery. Radiother Oncol. 1996;41:215–219
  76. Knox SJ, Goris ML, Tempero M, et al. Phase II trial of yttrium-90-DOTA-biotin pretargeted by NR-LU-10 antibody/streptavidin in patients with metastatic colon cancer. Clin Cancer Res. 2000;6:406–414
  77. Melis M, Krenning EP, Bernard BF, et al. Localisation and mechanism of renal retention of radiolabelled somatostatin analogues. Eur J Nucl Med Mol Imaging. 2005;32:1136–1143
  78. de Jong M, Breeman WA, Valkema R, et al. Combination radionuclide therapy using 177Lu- and 90Y-labeled somatostatin analogs. J Nucl Med. 2005;1(suppl 46):13S–17S
  79. Bolch WE, Bouchet LG, Robertson JS, et al. MIRD pamphlet No. 17: the dosimetry of nonuniform activity distributions–radionuclide S values at the voxel level (Medical Internal Radiation Dose Committee). J Nucl Med. 1999;40:11S–36S
  80. Bouchet LG, Bolch WE, Blanco HP, et al. MIRD Pamphlet No 19: absorbed fractions and radionuclide S values for six age-dependent multiregion models of the kidney. J Nucl Med. 2003;44:1113–1147
  81. Bouchet LG, Bolch WE, Weber DA, et al. MIRD Pamphlet No. 15: Radionuclide S values in a revised dosimetric model of the adult head and brain (Medical Internal Radiation Dose). J Nucl Med. 1999;40:62S–101S
  82. Howell RW, Wessels BW, Loevinger R, et al. The MIRD perspective 1999 (Medical Internal Radiation Dose Committee). J Nucl Med. 1999;40:3S–10S
  83. Valkema R, Pauwels SA, Kvols LK, et al. Long-term follow-up of renal function after peptide receptor radiation therapy with (90)Y-DOTA(0), Tyr(3)-octreotide and (177)Lu-DOTA(0), Tyr(3)-octreotate. J Nucl Med. 2005;1(suppl 46):83S–91S
  84. Barone R, Borson-Chazot F, Valkema R, et al. Patient-specific dosimetry in predicting renal toxicity with (90)Y-DOTATOC: relevance of kidney volume and dose rate in finding a dose-effect relationship. J Nucl Med. 2005;1(suppl 46):99S–106S
  85. Breitz H. Dosimetry in a myeloablative setting. Cancer Biother Radiopharm. 2002;17:119–128
  86. George JN. The role of ADAMTS13 in the pathogenesis of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Clin Adv Hematol Oncol. 2005;3:627–632
  87. Akabani G, Cokgor I, Coleman RE, et al. Dosimetry and dose-response relationships in newly diagnosed patients with malignant gliomas treated with iodine-131-labeled anti-tenascin monoclonal antibody 81C6 therapy. Int J Radiat Oncol Biol Phys. 2000;46:947–958
  88. Paganelli G, Zoboli S, Cremonesi M, et al. Receptor-mediated radionuclide therapy with 90Y-DOTA-D-Phe1-Tyr3-Octreotide: Preliminary report in cancer patients. Cancer Biother Radiopharm. 1999;14:477–483
  89. Pizer BL, Papanastassiou V, Moseley R, et al. Meningeal leukemia and medulloblastoma: Preliminary experience with intrathecal radioimmunotherapy. Antibody Immunoconj Radiopharm. 1991;4:753
  90. Riva P, Arista A, Tison V, et al. Intralesional radioimmunotherapy of malignant gliomas (An effective treatment in recurrent tumors). Cancer. 1994;73:1076–1082
  91. Paganelli G, Grana C, Chinol M, et al. Antibody-guided three-step therapy for high grade glioma with yttrium-90 biotin. Eur J Nucl Med. 1999;26:348–357
  92. Riva P, Arista A, Franceschi G, et al. Local treatment of malignant gliomas by direct infusion of specific monoclonal antibodies labeled with 131I: Comparison of the results obtained in recurrent and newly diagnosed tumors. Cancer Res. 1995;55:5952s–5956s
  93. Richardson RB, Kemshead JT, Davies AG, et al. Dosimetry of intrathecal iodine131 monoclonal antibody in cases of neoplastic meningitis. Eur J Nucl Med. 1990;17:42–48
  94. Brown MT, Coleman RE, Friedman AH, et al. Intrathecal 131I-labeled antitenascin monoclonal antibody 81C6 treatment of patients with leptomeningeal neoplasms or primary brain tumor resection cavities with subarachnoid communication: Phase I trial results. Clin Cancer Res. 1996;2:963–972
  95. Kemshead JT, Hopkins K, Pizer B, et al. Dose escalation with repeated intrathecal injections of 131I-labelled MAbs for the treatment of central nervous system malignancies. Br J Cancer. 1998;77:2324–2330
  96. Nieder C, Grosu AL, Andratschke NH, et al. Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. Int J Radiat Oncol Biol Phys. 2006;66:1446–1449
  97. Wahl RL. Tositumomab and (131)I therapy in non-Hodgkin's lymphoma. J Nucl Med. 2005;46(suppl 1):128S–140S
  98. Liu SY, Eary JF, Petersdorf SH, et al. Follow-up of relapsed B-cell lymphoma patients treated with iodine-131-labeled anti-CD20 antibody and autologous stem-cell rescue. J Clin Oncol. 1998;16:3270–3278
  99. Bal CS, Kumar A, Pant GS. Radioiodine dose for remnant ablation in differentiated thyroid carcinoma: A randomized clinical trial in 509 patients. J Clin Endocrinol Metab. 2004;89:1666–1673
  100. Hanscheid H, Lassmann M, Luster M, et al. Iodine biokinetics and dosimetry in radioiodine therapy of thyroid cancer: Procedures and results of a prospective international controlled study of ablation after rhTSH or hormone withdrawal. J Nucl Med. 2006;47:648–654
  101. Press OW, Eary JF, Appelbaum FR, et al. Radiolabeled-antibody therapy of B-cell lymphoma with autologous bone marrow support. N Engl J Med. 1993;329:1219–1224
  102. Chiesa C, Botta F, Di Betta E, et al. Dosimetry in myeloablative (90)Y-labeled ibritumomab tiuxetan therapy: Possibility of increasing administered activity on the base of biological effective dose evaluation (Preliminary results). Cancer Biother Radiopharm. 2007;22:113–120
  103. Breitz HB, Weiden PL, Vanderheyden JL, et al. Clinical experience with rhenium-186-labeled monoclonal antibodies for radioimmunotherapy: Results of phase I trials. J Nucl Med. 1992;33:1099–1109
  104. Matthews DC, Appelbaum FR, Eary JF, et al. Phase I study of (131)I-anti-CD45 antibody plus cyclophosphamide and total body irradiation for advanced acute leukemia and myelodysplastic syndrome. Blood. 1999;94:1237–1247
  105. Carabasi M, Khazaeli MB, Tilden AB, et al. Autologous stem cell transplantation for breast and prostate cancer after combined modality therapy with radioimmunotherapy plus external beam radiation. Blood. 1999;94:333a
  106. Dancey JE, Shepherd FA, Paul K, et al. Treatment of nonresectable hepatocellular carcinoma with intrahepatic 90Y-microspheres. J Nucl Med. 2000;41:1673–1681
  107. Yu CX, Hisley C, Kennedy A. tumor volume-based prescription for the treatment of liver cancer with micro-sphere infusion. Int J Radiat Oncol Biol Phys. 2002;54:126–127
  108. Breitz HB, Fisher DR, Goris ML, et al. Radiation absorbed dose estimation for 90Y-DOTA-biotin with pretargeted NR-LU-10/streptavidin. Cancer Biother Radiopharm. 1999;14:381–395
  109. Epenetos AA, Courtenay-Luck N, Dhokia B, et al. Antibody-guided irradiation of hepatic metastases using intrahepatically administered radiolabelled anti-CEA antibodies with simultaneous and reversible hepatic blood flow stasis using biodegradable starch microspheres. Nucl Med Commun. 1987;8:1047–1058
  110. Stewart JS, Hird V, Snook D, et al. Intraperitoneal radioimmunotherapy for ovarian cancer: Pharmacokinetics, toxicity, and efficacy of I-131 labeled monoclonal antibodies. Int J Radiat Oncol Biol Phys. 1989;16:405–413
  111. Raymond JP, Izembart M, Marliac V, et al. Temporary ovarian failure in thyroid cancer patients after thyroid remnant ablation with radioactive iodine. J Clin Endocrinol Metab. 1989;69:186–190
  112. Pacini F, Gasperi M, Fugazzola L, et al. Testicular function in patients with differentiated thyroid carcinoma treated with radioiodine. J Nucl Med. 1994;35:1418–1422
  113. Meredith R, Alvarez RD, Khazaeli MB, et al. Intraperitoneal radioimmunotherapy for refractory epithelial ovarian cancer with 177 Lu-CC49. Minerva Biotechnol. 1998;10:100–107
  114. Liu T, Meredith RF, Saleh MN, et al. Correlation of toxicity with treatment parameters for 131I-CC49 radioimmunotherapy in three phase II clinical trials. Cancer Biother Radiopharm. 1997;12:79–87
  115. Weiden PL, Breitz HB, Press O, et al. Pretargeted radioimmunotherapy (PRIT) for treatment of non-Hodgkin's lymphoma (NHL): Initial phase I/II study results. Cancer Biother Radiopharm. 2000;15:15–29
  116. Knox SJ, Goris ML, Trisler K, et al. Yttrium-90-labeled anti-CD20 monoclonal antibody therapy of recurrent B-cell lymphoma. Clin Cancer Res. 1996;2:457–470
  117. Williams G, Palmer MR, Parker JA, et al. Extravazation of therapeutic yttrium-90-ibritumomab tiuxetan (zevalin): a case report. Cancer Biother Radiopharm. 2006;21:101–105
  118. Bradley JD, Paulus R, Graham MV, et al. Phase II trial of postoperative adjuvant paclitaxel/carboplatin and thoracic radiotherapy in resected stage II and IIIA non-small-cell lung cancer: Promising long-term results of the Radiation Therapy Oncology Group–RTOG 9705. J Clin Oncol. 2005;23:3480–3487
  119. Fisher D, Rajon D, Breitz H, et al. Dosimetry model for radioactivity localized to intestinal mucosa. Cancer Biother Radiopharm. 2004;19:293–307
  120. Spanos WJ, Day T, Abner A, et al. Complications in the use of intra-abdominal 32P for ovarian carcinoma. Gynecol Oncol. 1992;45:243–247
  121. O'Donoghue J. Relevance of external beam dose-response relationships to kidney toxicity associated with radionuclide therapy. Cancer Biother Radiopharm. 2004;19:378–387
  122. Meredith RF, Khazaeli MB, Plott G, et al. Comparison of diagnostic and therapeutic doses of 131I-Lym-1 in patients with non-Hodgkin's lymphoma. Antibody Immunoconj Radiopharm. 1993;6:1
  123. Macey DJ, Grant EJ, Kasi L, et al. Effect of recombinant alpha-interferon on pharmacokinetics, biodistribution, toxicity, and efficacy of 131I-labeled monoclonal antibody CC49 in breast cancer: A phase II trial. Clin Cancer Res. 1997;3:1547–1555
  124. Clarke KG, Odom-Maryon TL, Williams LE, et al. Intrapatient consistency of imaging biodistributions and their application to predicting therapeutic doses in a phase I clinical study of 90Y-based radioimmunotherapy. Med Phys. 1999;26:799–809
  125. Eary JF, Pollard KR, Durack LD, et al. Post therapy imaging in high dose I-131 radioimmunotherapy patients. Med Phys. 1994;21:1157–1162
  126. Hartmann Siantar CL, DeNardo GL, DeNardo SJ. Impact of nodal regression on radiation dose for lymphoma patients after radioimmunotherapy. J Nucl Med. 2003;44:1322–1329
  127. Graham MV, Purdy JA, Emami B, et al. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys. 1999;45:323–329
  128. Yorke ED, Jackson A, Rosenzweig KE, et al. Correlation of dosimetric factors and radiation pneumonitis for non-small-cell lung cancer patients in a recently completed dose escalation study. Int J Radiat Oncol Biol Phys. 2005;63:672–682
  129. Bradley JD, Hope A, El Naqa I, et al. A nomogram to predict radiation pneumonitis, derived from a combined analysis of RTOG 9311 and institutional data. Int J Radiat Oncol Biol Phys. 2007;69:985–992
  130. Mehta V. Radiation pneumonitis and pulmonary fibrosis in non-small-cell lung cancer: Pulmonary function, prediction, and prevention. Int J Radiat Oncol Biol Phys. 2005;63:5–24
  131. Chang BK, Timmerman RD. Stereotactic body radiation therapy: A comprehensive review. Am J Clin Oncol. 2007;30:637–644
  132. Ho AY, Fan G, Atencio DP, et al. Possession of ATM sequence variants as predictor for late normal tissue responses in breast cancer patients treated with radiotherapy. Int J Radiat Oncol Biol Phys. 2007;69:677–684
  133. Couturier O, Supiot S, Degraef-Mougin M, et al. Cancer radioimmunotherapy with alpha-emitting nuclides. Eur J Nucl Med Mol Imaging. 2005;32:601–614
  134. Bruland OS, Nilsson S, Fisher DR, et al. High-linear energy transfer irradiation targeted to skeletal metastases by the alpha-emitter 223Ra: Adjuvant or alternative to conventional modalities?. Clin Cancer Res. 2006;12:6250s–6257s
  135. Jurcic J. Alpha-particle Immunotherapy for acute myeloid leukemia (AML) with Bismuth-213 and Actinium-225. Cancer Biother Radiopharm. 2006;21:396
  136. Quang TS, Brady LW. Radioimmunotherapy as a novel treatment regimen: 125I-labeled monoclonal antibody 425 in the treatment of high-grade brain gliomas. Int J Radiat Oncol Biol Phys. 2004;58:972–975

 Support for some clinical trials was from NIH M01 RR-00032.

PII: S0001-2998(08)00068-8

doi: 10.1053/j.semnuclmed.2008.05.001

Seminars in Nuclear Medicine
Volume 38, Issue 5 , Pages 347-357 , September 2008

Article Tools