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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 10/2014

01-10-2014 | Review Article

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

Authors: Lidia Strigari, Mark Konijnenberg, Carlo Chiesa, Manuel Bardies, Yong Du, Katarina Sjögreen Gleisner, Michael Lassmann, Glenn Flux

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2014

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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.
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Metadata
Title
The evidence base for the use of internal dosimetry in the clinical practice of molecular radiotherapy
Authors
Lidia Strigari
Mark Konijnenberg
Carlo Chiesa
Manuel Bardies
Yong Du
Katarina Sjögreen Gleisner
Michael Lassmann
Glenn Flux
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2014
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-014-2824-5

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