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Locoregional Radionuclide Therapy of Primary and Metastatic Cancers

  • Franklin C. Wong
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Locoregional radionuclide cancer therapy (LRCT) has been applied to treat human cancers with increasing frequency because of better understanding of loculation and biodistribution of radiopharmaceuticals and translation of radiobiology from external beam radiotherapy. It is aided by radiation dosimetry derived from simulation of anthropomorphic models and imaging of radiopharmaceuticals. Theoretical advantages of LRCT include higher delivery efficiency, larger therapeutic windows, less radioactivities required, lower systemic toxicities, and simpler radiation dosimetry models. Other potential advantages include suppression of locoregional immunologic resistance so that immune recognition and amplification may be recruited for current therapy (analogous to the rare Ascopal effect) and prevention of recurrence. Since the main requirement is radiopharmaceutical proximity to the tumor for geographic targeting, requirement for chemical specificity is less stringent as long as the radionuclide is retained by the tumor for ablation by radioactive emissions. In practice, many commercially available radiopharmaceuticals may be contemplated to overcome some of the regulatory hurdles for productions and distribution. The disadvantages mostly stem from shorter range of emissions to eradicate larger tumors and inability to treat distant metastases which are nevertheless treated by other cancer therapy modalities such as surgery, external beam radiation, and chemotherapy. This chapter reviews theoretical aspects of LRCT along with examples of current practice of LRCT in different human tissues and organs, including interstitial, intracavitary, intrathecal, interstitial, pericaradial, peritoneal and peripleural spaces and tumors. The main goal is to shine light on what is possible and what is in practice in the real world and what can be done to bring these realms together. 

 

Keywords

Pleural Fluid Cerebral Spinal Fluid Malignant Pleural Effusion Radionuclide Therapy Malignant Ascites 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg  2012

Authors and Affiliations

  1. 1.Nuclear Medicine and Neuro-Oncology, M. D. Anderson Cancer CenterThe University of TexasHoustonUSA

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