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Journal of Nuclear Medicine

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OtherClinical Investigations (Human)

A rapid and safe infusion protocol for lutetium-177 peptide receptor radionuclide therapy

Sander C. Ebbers, Maarten W. Barentsz, Bart de Keizer, Gerard C. Krijger, Marnix G.E.H. Lam and Arthur J.A.T. Braat
Journal of Nuclear Medicine November 2020, jnumed.120.252494; DOI: https://doi.org/10.2967/jnumed.120.252494
Sander C. Ebbers
University Medical Center Utrecht, Netherlands
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Maarten W. Barentsz
University Medical Center Utrecht, Netherlands
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Bart de Keizer
University Medical Center Utrecht, Netherlands
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Gerard C. Krijger
University Medical Center Utrecht, Netherlands
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Marnix G.E.H. Lam
University Medical Center Utrecht, Netherlands
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Arthur J.A.T. Braat
University Medical Center Utrecht, Netherlands
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Abstract

Purpose: Peptide receptor radionuclide therapy (PRRT) with 177Lu-labelled somatostatin analogues in patients with somatostatin-receptor expressing tumors is often performed using administration protocols prescribing a 30 minutes infusion time. The most often used method of infusion is the gravity method, by which the complete dose is effectively administered exponentially. However, there is no evidence to explicitly support an infusion time of 30 minutes. This study aims to investigate the safety of an infusion time of less than 5 minutes. Methods: A cohort study was performed, examining the biochemical and clinical toxicity after PRRT when using a fast infusion protocol with a maximum infusion time of 5 minutes. Data on patient characteristics, laboratory tests, follow-up visits and pre- and post-treatment imaging using 68Ga-DOTA-TOC PET/CT from patients treated with PRRT at the University Medical Center Utrecht (UMC Utrecht) were collected. All patients receiving PRRT using the fast-infusion protocol were included. If no laboratory or clinical follow-up was available, patients were excluded. In addition, a laboratory experiment was performed, simulating the standard-infusion protocol using the gravity method. Results: 31 patients were included, who were treated using the fast infusion protocol. Clinical toxicity mainly consisted of grade 1/2 fatigue (87.1%) and grade 1 nausea and/or vomiting (67.7%) during follow-up. No acute or long term clinical toxicity possibly related to the fast infusion protocol was reported. Grade 3/4 hematological toxicity occurred after PRRT in one patient (3.2%). No grade 3/4 renal toxicity occurred. The laboratory experiment showed that when using the gravity method for infusion, half of the activity is infused after 3.5 minutes, and 95% is infused within 15 minutes. Conclusion: A faster infusion of PRRT using an infusion time of less than 5 minutes is safe and feasible in clinical practice.

  • Oncology: Endocrine
  • Radionuclide Therapy
  • Radiopharmaceuticals
  • Peptide receptor radionuclide therapy
  • [177Lu]Lu-DOTA-TATE;
  • fast infusion
  • infusion protocol
  • Copyright © 2020 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

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Journal of Nuclear Medicine: 62 (4)
Journal of Nuclear Medicine
Vol. 62, Issue 4
April 1, 2021
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A rapid and safe infusion protocol for lutetium-177 peptide receptor radionuclide therapy
Sander C. Ebbers, Maarten W. Barentsz, Bart de Keizer, Gerard C. Krijger, Marnix G.E.H. Lam, Arthur J.A.T. Braat
Journal of Nuclear Medicine Nov 2020, jnumed.120.252494; DOI: 10.2967/jnumed.120.252494

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A rapid and safe infusion protocol for lutetium-177 peptide receptor radionuclide therapy
Sander C. Ebbers, Maarten W. Barentsz, Bart de Keizer, Gerard C. Krijger, Marnix G.E.H. Lam, Arthur J.A.T. Braat
Journal of Nuclear Medicine Nov 2020, jnumed.120.252494; DOI: 10.2967/jnumed.120.252494
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Keywords

  • Oncology: Endocrine
  • Radionuclide Therapy
  • Radiopharmaceuticals
  • Peptide receptor radionuclide therapy
  • [177Lu]Lu-DOTA-TATE;
  • fast infusion
  • infusion protocol
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