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The evidence base for the use of internal dosimetry in the clinical practice of molecular radiotherapy

  • Lidia Strigari
  • Mark Konijnenberg
  • Carlo Chiesa
  • Manuel Bardies
  • Yong Du
  • Katarina Sjögreen Gleisner
  • Michael Lassmann
  • Glenn Flux
Review Article

Abstract

Molecular radiotherapy (MRT) has demonstrated unique therapeutic advantages in the treatment of an increasing number of cancers. As with other treatment modalities, there is related toxicity to a number of organs at risk. Despite the large number of clinical trials over the past several decades, considerable uncertainties still remain regarding the optimization of this therapeutic approach and one of the vital issues to be answered is whether an absorbed radiation dose–response exists that could be used to guide personalized treatment. There are only limited and sporadic data investigating MRT dosimetry. The determination of dose–effect relationships for MRT has yet to be the explicit aim of a clinical trial. The aim of this article was to collate and discuss the available evidence for an absorbed radiation dose–effect relationships in MRT through a review of published data. Based on a PubMed search, 92 papers were found. Out of 79 studies investigating dosimetry, an absorbed dose–effect correlation was found in 48. The application of radiobiological modelling to clinical data is of increasing importance and the limited published data on absorbed dose–effect relationships based on these models are also reviewed. Based on National Cancer Institute guideline definition, the studies had a moderate or low rate of clinical relevance due to the limited number of studies investigating overall survival and absorbed dose. Nevertheless, the evidence strongly implies a correlation between the absorbed doses delivered and the response and toxicity, indicating that dosimetry-based personalized treatments would improve outcome and increase survival.

Keywords

Molecular radiotherapy Dosimetry Dose–effect relationship 

Notes

Conflicts of interest

None.

Supplementary material

259_2014_2824_MOESM1_ESM.doc (18 kb)
ESM 1 (DOCX 18.5 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Lidia Strigari
    • 1
  • Mark Konijnenberg
    • 2
  • Carlo Chiesa
    • 3
  • Manuel Bardies
    • 4
  • Yong Du
    • 5
  • Katarina Sjögreen Gleisner
    • 6
  • Michael Lassmann
    • 7
  • Glenn Flux
    • 8
  1. 1.Laboratory of Medical Physics and Expert SystemsRegina Elena National Cancer InstituteRomeItaly
  2. 2.Department of Nuclear MedicineErasmus MCRotterdamThe Netherlands
  3. 3.Department of Nuclear MedicineInstituto Nazionale TumoriMilanItaly
  4. 4.Centre de Recherche en Cancerologie de ToulouseUMR 1037 INSERM / Université Paul SabatierToulouseFrance
  5. 5.Department of Nuclear Medicine and PET/CTRoyal Marsden NHS Foundation TrustSuttonUK
  6. 6.Medical Radiation Physics, Clinical SciencesLundSweden
  7. 7.Department of Nuclear MedicineUniversity of WürzburgWürzburgGermany
  8. 8.Joint Department of PhysicsRoyal Marsden NHS Foundation Trust & Institute of Cancer ResearchSuttonUK

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