Radionuclide therapies
Radionuclide therapy is increasingly used in the treatment of cancer, a development made possible by the identification of an increasing number of cancer biomarkers that allow the use of targeted radionuclide therapy. Lymphomas, for instance, can be treated with radiolabelled antibodies that are taken up by cancer tissue and destroy it by means of radiation and antibody formation. This form of radionuclide therapy is also known as radioimmunotherapy.
Neuroendocrine tumours are rare cancers that can be treated with short-range radiation using radiolabelled peptides that are readily taken up by cancer tissue (peptide-receptor radionuclide therapy). The most common form of radionuclide therapy is the use of radioactive iodine in thyroid cancer, where even the cancer metastases collect iodine and shrink in size as their cells are locally destroyed by short-range radiation. Pain caused by bone metastases can be treated using short-range radiopharmaceuticals that are taken up by bone.
In radionuclide therapy, a radioactive substance is administered to the patient intravenously or orally, following which it penetrates via the patient’s normal metabolism into the target organ or tissue, where it delivers local radiation for a short time. This radiation effect is utilised in both diagnostics and radiotherapy.
The radiopharmaceutical used in each particular case is selected individually. The radioisotopes most commonly used in cancer treatments are those of samarium, iodine, rhenium, lutetium and yttrium.
The effect of radionuclide therapy (also known as radioisotope therapy, radiopharmaceutical therapy and molecular radiotherapy) is based on local radiation emitted by a radioactive substance that is taken up by cancer cells and destroys them. Finding a combination that is taken up by the tumour and destroys cancer cells is always an individually tailored process that requires expertise from a broad range of specialties.
PET-CT and SPECT-CT imaging is an integral part of radionuclide therapy. It gives an idea of the extent to which the radioactive material accumulates in the tissues and helps provide an estimate of the required therapeutic dose and its effects. For good treatment results, a sufficient dose of radiation must be delivered to the tumour. This is confirmed by imaging.
It may sometimes take several treatment sessions to achieve a sufficient radiation dose.
Radionuclide therapies have long been used to treat thyroid cancer, hyperthyroidism, and benign thyroid hyperplasia using iodine-131 (131I). Since the early 2000s, various radionuclide therapies have also been used to treat non-Hodgkin’s lymphoma. The treatments are based on radiolabelled antibodies that combine the cytotoxic (cell-destroying) effects of the antibody with those of radiation (so-called radioimmunotherapy).
The potential of radioisotope therapy to treat certain rarer solid tumours (e.g. phaeochromocytomas and neuroblastomas) and haematological conditions (e.g. leukaemia), as well as in intracavitary and intravascular treatments, has been known for some time. The number of patients treated has nevertheless been small. The majority of these treatment methods require collaboration between physicians from a number specialties, and only a few centres in the world have been able to carry out such treatments.
Today, radionuclide therapies are included in Scandinavian treatment guidelines for neuroendocrine tumours. Very recently, radionuclide therapies have also been introduced in the treatment of pancreatic cancer, liver cancer and prostate cancer.
Docrates Hospital was the first to start lutetium treatments in Finland >>
Radiation therapy >>
Drug therapy >>
Surgical treatments >>
New treatment methods >>
Neuroendocrine tumours are rare cancers that can be treated with short-range radiation using radiolabelled peptides that are readily taken up by cancer tissue (peptide-receptor radionuclide therapy). The most common form of radionuclide therapy is the use of radioactive iodine in thyroid cancer, where even the cancer metastases collect iodine and shrink in size as their cells are locally destroyed by short-range radiation. Pain caused by bone metastases can be treated using short-range radiopharmaceuticals that are taken up by bone.
In radionuclide therapy, a radioactive substance is administered to the patient intravenously or orally, following which it penetrates via the patient’s normal metabolism into the target organ or tissue, where it delivers local radiation for a short time. This radiation effect is utilised in both diagnostics and radiotherapy.
The radiopharmaceutical used in each particular case is selected individually. The radioisotopes most commonly used in cancer treatments are those of samarium, iodine, rhenium, lutetium and yttrium.
The effect of radionuclide therapy (also known as radioisotope therapy, radiopharmaceutical therapy and molecular radiotherapy) is based on local radiation emitted by a radioactive substance that is taken up by cancer cells and destroys them. Finding a combination that is taken up by the tumour and destroys cancer cells is always an individually tailored process that requires expertise from a broad range of specialties.
PET-CT and SPECT-CT imaging is an integral part of radionuclide therapy. It gives an idea of the extent to which the radioactive material accumulates in the tissues and helps provide an estimate of the required therapeutic dose and its effects. For good treatment results, a sufficient dose of radiation must be delivered to the tumour. This is confirmed by imaging.
It may sometimes take several treatment sessions to achieve a sufficient radiation dose.
Radionuclide therapies have long been used to treat thyroid cancer, hyperthyroidism, and benign thyroid hyperplasia using iodine-131 (131I). Since the early 2000s, various radionuclide therapies have also been used to treat non-Hodgkin’s lymphoma. The treatments are based on radiolabelled antibodies that combine the cytotoxic (cell-destroying) effects of the antibody with those of radiation (so-called radioimmunotherapy).
The potential of radioisotope therapy to treat certain rarer solid tumours (e.g. phaeochromocytomas and neuroblastomas) and haematological conditions (e.g. leukaemia), as well as in intracavitary and intravascular treatments, has been known for some time. The number of patients treated has nevertheless been small. The majority of these treatment methods require collaboration between physicians from a number specialties, and only a few centres in the world have been able to carry out such treatments.
Today, radionuclide therapies are included in Scandinavian treatment guidelines for neuroendocrine tumours. Very recently, radionuclide therapies have also been introduced in the treatment of pancreatic cancer, liver cancer and prostate cancer.
Docrates Hospital was the first to start lutetium treatments in Finland >>
Radiation therapy >>
Drug therapy >>
Surgical treatments >>
New treatment methods >>