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Estimates of Radiation Absorbed Dose for Intraperitoneally Administered Iodine-131 Radiolabeled B72.3 Monoclonal Antibody in Patients with Peritoneal Carcinomatoses

Nuclear Medicine Service, Sloan-Kettering Memorial Cancer Center, New York, New York
Department of Nuclear Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
Laboratory of Tumor Immunology and Biology, Division of Cancer Biology, Surgical Oncology Branch, and Radiation Oncology Branch, Division of Cancer Treatment, National Cancer Institute, Bethesda, Maryland
Radiopharmaceutical Internal Dose Information Center, Oak Ridge Associated Universities, Oak Ridge, Tennessee

Correspondence: For reprints contact: Steven M. Larson, MD, Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.

ABSTRACT

Using a newly available model for determining estimates of radiation absorbed dose of radioisotopes administered intraperitoneally, we have calculated absorbed dose to tumor and normal tissues based on a surgically controlled study of radiolabeled antibody distribution. Ten patients with peritoneal carcinomatosis received intraperitoneal injections of the murine monoclonal antibody B72.3 radiolabeled with ¹³¹I. Biodistribution studies were performed using nuclear medicine methods until laparotomy at 4–14 days after injection. Surgical biopsies of normal tissues and tumor were obtained. The marrow was predicted to be the critical organ, with maximum tolerated dose [200 rad (2 Gy) to marrow] expected at about 200 mCi (7.4 GBq). In patients with large intraperitoneal tumor deposits, the tumor itself is an important source tissue for radiation exposure to normal tissues. Local "hotspots" for tumor-absorbed dose were observed, with maximum tumor-absorbed dose calculated at 11000 rad (11 Gy) per 100 mCi (3.7GBq) administered intraperitoneal; however, tumor rad dose varied considerably. This may pose serious problems for curative therapy, especially in patients with large tumor burdens.