Combining radionuclide therapy with radiotherapy
- Author(s)
- Kashyap Karri, R; Hicks, RJ;
- Journal Title
- In: Signore, A. (ed) Nuclear Medicine and Molecular Imaging, Volume 4
- Publication Type
- Book section
- Abstract
- Radionuclide therapy is now an established therapeutic option in several cancers. Building on the long experience with the use of radioiodine therapy for thyroid cancer management, more recent applications have included peptide receptor radionuclide therapy for neuroendocrine neoplasia and PSMA-based radioligand therapy for prostate cancer. As understanding of cancer biology is advancing more and more theranostic targets are being identified. The beauty of the theranostic paradigm is the ability to identify sites of disease that are amenable to therapeutic targeting by virtue of high uptake of a diagnostic version of the therapeutic agent. As a corollary of this, the ability to recognize sites of disease that lack the target or express it at insufficient levels to deliver meaningful irradiation, allows selection of alternative therapies. The heterogeneity of many cancers leads to some patients having a combination of metastatic disease both with and without adequate target expression. Sequential PET/CT imaging with the targeting ligand and FDG is an attractive diagnostic option for characterizing the molecular imaging phenotype of cancer sites and to selecting the most appropriate treatment. When the disease unsuitable for radionuclide therapy is limited in extent, combination of radionuclide therapy with external beam radiotherapy is an attractive option to achieve disease control. This may include sites that are estimated to receive inadequate radiation by either approach alone due to safety constraints on dose delivery. Adjuvant radiotherapy to sites at risk of pathological fracture or neurological compromise is another example of the complementary use of these therapeutic modalities. In this chapter, we discuss the theoretical and practical considerations of combining radionuclide therapy with radiotherapy.
- Publisher
- Elsevier
- Keywords
- Neuroendocrine neoplasia; Peptide receptor radionuclide therapy (PRRT); Positron emission tomography (PET/CT); Prostate cancer; PSMA; Radioiodine; Radionuclide therapy; Radiotherapy; Thyroid cancer
- Department(s)
- Cancer Imaging
- Publisher's Version
- https://doi.org/10.1016/B978-0-12-822960-6.00081-8
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-12-19 03:18:26
Last Modified: 2024-12-19 03:23:08