177Lu-DOTATATE ile Tedavi Edilen Nöroendokrin Tümörlü Hastalarda Renal Dozimetri ve Nefrotoksisite Değerlendirmesi

Öz

Amaç: Bu çalışmanın amacı, nöroendokrin tümör tanısı almış 22 hastada, 5550 MBq (150 mCi) 177Lu-DOTATATE radyofarmasötik uygulaması sonrasında hesaplanan böbrek dozları ve glomerüler filtrasyon hızlarına (GFR) dayalı olarak dozimetri yapmak ve renal toksisiteyi değerlendirmektir. Materyal ve Metod: 35 ile 80 yaşları arasında, 14 erkek ve 8 kadından oluşan hastalar, lezyonları belirlemek için 68Ga-DOTATATE PET/CT taramaları geçirmiş ve ardından tedavi planlaması yapılmıştır. 177Lu-DOTATATE tüm vücut görüntüleme kullanılarak dozimetri, uygulamadan 4, 24, 48 ve 72 saat sonra gerçekleştirilmiştir. Bulgular: Sonuçlarımıza göre, ortalama tedavi döngüsü sayısı 5±1, ortalama toplam böbrek dozu 24.32±3.5 (Gy), ortalama toplam BED dozu 27.9±2.5 (Gy), ortalama tüm vücut dozu 1.83±0.4 (Gy) ve ortalama GFR 69.95±12.2 olarak bulunmuştur. Böbrek dozları ile GFR arasındaki korelasyon R²=0.7945 olarak hesaplanmıştır. Toplam böbrek dozları ile toplam böbrek BED dozları arasındaki ilişkinin önemi Mann-Whitney U testi kullanılarak değerlendirilmiştir (p=0.0244). Sonuç: Çalışma, tedavi döngüsü sayısı arttıkça toplam böbrek dozunun da arttığını; ancak GFR'de hızlı düşüşlerin gözlemlenmediğini ve tedavi edilen hastaların hiçbirinin böbreklerde toksik dozlara ulaşmadığını bulmuştur.

Anahtar Kelimeler

• MIRD metodu
• 68Ga DOTATATE
• 177Lu DOTATATE
• nöroendokrin tümör
• radyonüklit dozimetri

Assessment of Renal Dosimetry and Nephrotoxicity in Patients with Neuroendocrine Tumors Treated with 177Lu-DOTATATE

Abstract

Aim: This study aimed to conduct dosimetry and evaluate renal toxicity based on calculated kidney doses and glomerular filtration rates (GFR) in 22 patients diagnosed with neuroendocrine tumors following the administration of 5550 MBq (150 mCi) of 177Lu-DOTATATE radiopharmaceutical. Materials and Methods: Patients, aged between 35 and 80, including 14 males and 8 females, underwent 68Ga-DOTATATE PET/CT scans to identify lesions and subsequently received treatment planning. Dosimetry of ¹⁷⁷Lu-DOTATATE was performed using whole-body imaging based on scans acquired at 4, 24, 48, and 72 hours post-administration. Results: According to our results, the average number of treatment cycles was 5±1, with an average total kidney dose of 24.32±3.5 (Gy), average total BED dose of 27.9±2.5 (Gy), average whole-body dose of 1.83±0.4 (Gy), and average GFR of 69.95±12.2. The correlation between kidney doses and GFR was calculated as R2=0.7945. The significance of the relationship between total kidney doses and total kidney BED doses was evaluated using the Mann-Whitney U test (p=0.0244). Conclusion: The study found that as the number of treatment cycles increased, the total kidney dose also increased; however, rapid declines in GFR were not observed, and none of the treated patients reached toxic doses in the kidneys.

Keywords

• MIRD method
• 68Ga-DOTATATE
• 177Lu-DOTATATE
• neuroendocrine tumor
• radionuclide dosimetry

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