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AAPM Reports - Radiolabeled Antibody Tumor Dosimetry
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Report No. 040 - Radiolabeled Antibody Tumor Dosimetry (1993)

Category: Reports

Through the sponsorship of the Nuclear Medicine Committee of the American Association of Physicists in Medicine (AAPM), a Nuclear Medicine Task Group 2, “Dosimetry of Radiolabeled Antibodies” was established in July 1987 under the Chairmanship of Dr. Barry Wessels to produce reports on radiolabeled antibody dosimetry, which would include an extensive literature search and an analysis of how to approach the dosimetry to normal tissues and tumor of radiolabeled antibody therapy (radioimmunotherapy). The first report published in 1990 summarized a “Bone Marrow Dosimetry and Toxicity for Radiolabeled Antibodies” symposium held in conjunction with the 1988 American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting. In 1989, the Steering Committee on the Nuclear Medicine Task Group 2 decided at the Society of Nuclear Medicine (SNM) Annual Meeting that the new focus area for the Task Group would be tumor dosimetry for radiolabeled antibody therapy. The Task Group members and invited guests active in radiolabeled antibody research from the physics, radiation biology, nuclear medicine, and oncology communities had been invited to attend meetings to plan and prepare this report on “Radiolabeled Antibody Tumor Dosimetry.” These meetings were held in conjunction with the annual meetings of the ASTRO, the AAPM, the SNM, the “International Conference on Monoclonal Antibody Immunoconjugates for Cancer” and the “Third Conference on Radioimmunodetection and Radioimmunotherapy of Cancer.” The purpose of this report is to provide an extensive literature search and review the various approaches that are being pursued in preclinical and clinical studies to estimate tumor dosimetry associated with radioimmunotherapy (RIT), and to suggest future directions for dosimetry research in this field. Included in this report is a discussion of the radiobiological aspects of tumor dosimetry of radiolabeled antibody therapy. Radiolabeled monoclonal antibodies (MoAbs) offer the potential of highly localized, targeted radiation treatment of cancer. The effectiveness of radiation treatment of malignant disease is correlated with the total dose delivered, with increasing dose producing increasing cell kill. Similarly, normal tissue damage is also directly related to the total dose deposited. The ability to quantify the dose delivered to tumor and normal tissues when using radiolabeled MoAbs has been a perplexing problem. As noted in the review of a National Cancer Institute workshop, 2 techniques for evaluating the dosimetry of radiolabeled antibody therapy are essential to support the development of RIT in the treatment of neoplastic diseases. Radiation dosimetry is important for treatment planning and the assessment of results. It is necessary to determine the quantity of radiolabeled antibody to administer to maximize the radiation dose to the tumor while not exceeding tolerance levels of critical normal tissues, In contrast to external beam radiation therapy dosimetry, the tumor dosimetry for radiolabeled antibody therapy is dependent on a number of variables including: ( 1) kinetics of biodistribution, tumor uptake and retention of the radiolabeled antibody, (2) the uniformity of distribution of the radiolabeled antibody within tumor, (3) the radionuclide attached to the antibody, and (4) the radiobiological response of tumor cells to continuously decreasing low-doserate radiation. The 12 papers in this special issue of Medical Physics summarize the problems, various techniques that are being used to estimate the tumor dosimetry associated with radiolabeled antibody therapy, and future directions as highlighted below.

Medical Physics, 20, 499-501
http://dx.doi.org/10.1118/1.597044
ISBN: 978-1-563962-33-2

Keywords: Radioimmunotherapy, Dosimetry , Beta Emitters, Radiobiology
Nuclear Medicine Committee Task Group #2

Barry W. Wessels, A. Bertrand Brill, Donald J. Buchsbaum, Laurence P. Clarke, Darrell R. Fisher, John L. Humm, Timothy K. Johnson, Jerry L. Klein, Kenneth F. Koral, Cheuk S. Kwok, Virginia Langmuir, Peter K. Leichner, Daniel J. Macey, George Sgouros, Jeffry A. Siegel, Edward A. Silverstein, Mike Stabin, Sven-Erik Strand, Evelyn E. Watson, Lawrence E. Williams, Latresla A. Wilson, Ellen D. Yorke, Pat Zanzonico
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