Abstract
Aim: The spleen receives a high mean absorbed radiation dose during peptide receptor radionuclide therapy (PRRNT). The aim of this study is to correlate the radiation dose to spleen with the effect on blood cell count after PRRNT. Methods: Fifty-three neuroendocrine tumor (NET) patients were treated with 3.8–8.5 GBq 177Lu-DOTATATE or 177Lu-DOTATOC. Dosimetry was performed according to MIRD scheme. Eleven NET patients who had undergone splenectomy before PRRNT and who received 4.7–7.6 GBq 177Lu-DOTATATE or 177Lu-DOTATOC were selected as controls. RBC, WBC (total and differential), and platelet counts before and after each cycle of PRRNT were documented. Results: The median dose to the spleen in the study group was 6.34 Gy (2.32–20.06 Gy). There was no significant difference in the posttherapy changes in the blood cell counts (RBC, WBC, or platelets) between the study group and the control group. Mild hematological toxicity was found in 7 of the 53 (13.2%) patients in the study group and in 1 out of the 11 patients (9.1%) in the control group. However, there was no correlation between the incidence or grade of hematological toxicity and the dose to the spleen. Conclusion: This study demonstrates for the first time that hematological toxicity after PRRNT is not related to the radiation dose to the spleen.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Krenning EP, Kwekkeboom DJ, Valkema R, Pauwels S, Kvols LK, De Jong M (2004) Peptide receptor radionuclide therapy. Ann N Y Acad Sci 1014:234–245
Kwekkeboom DJ, de Herder WW, Kam BL, van Eijck CH, van Essen M, Kooij PP, Feelders RA, van Aken MO, Krenning EP (2008) Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0, Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol 26:2124–2130
Reubi JC, Kvols L, Krenning EP, Lamberts SWJ (1990) Distribution of somatostatin receptor in normal and tumour tissue. Metabolism 30(suppl 2):78–81
Swirski FK, Nahrendorf M, Etzrodt M, Wildgruber M, Cortez-Retamozo V, Panizzi P, Figueiredo JL, Kohler RH, Chudnovskiy A, Waterman P, Aikawa E, Mempel TR, Libby P, Weissleder R, Pittet MJ (2009) Identification of splenic reservoir monocytes and their deployment to inflammatory sites. Science 325:612–616
Wehrmann C, Senftleben S, Zachert C, Müller D, Baum RP (2007) Results of individual patient dosimetry in peptide receptor radionuclide therapy with 177Lu DOTA-TATE and 177Lu DOTA-NOC. Cancer Biother Radiopharm 22:406–416
Weinmann M, Becker G, Einsele H, Bamberg M (2001) Clinical indications and biological mechanisms of splenic irradiation in chronic leukaemias and myeloproliferative disorders. Radiother Oncol 58:235–246
van Essen M, Krenning EP, De Jong M, Valkema R, Kwekkeboom DJ (2007) Peptide receptor radionuclide therapy with radiolabelled somatostatin analogues in patients with somatostatin receptor positive tumours. Acta Oncol 46:723–734
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Kulkarni, H.R., Prasad, V., Schuchardt, C., Baum, R.P. (2013). Is There a Correlation Between Peptide Receptor Radionuclide Therapy-Associated Hematological Toxicity and Spleen Dose?. In: Baum, R., Rösch, F. (eds) Theranostics, Gallium-68, and Other Radionuclides. Recent Results in Cancer Research, vol 194. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27994-2_33
Download citation
DOI: https://doi.org/10.1007/978-3-642-27994-2_33
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-27993-5
Online ISBN: 978-3-642-27994-2
eBook Packages: MedicineMedicine (R0)