Radiopharmaceuticals have the ability to reach diseased cells and tissues, selectively irradiating them, and this allows therapeutic action to be focused solely at the target tissue, minimizing damage to surrounding healthy tissues. Radiopharmaceutical distribution is assessed prior to treatments using nuclear and molecular imaging methods, which allow for personalization of therapy.
Radiometabolic therapy
Radiometabolic therapy is the branch of nuclear medicine that deals with the treatment of various diseases, benign and malignant, using isotope-labeled radiopharmaceuticals emitting corpuscular radiation.
Diagnosis and therapy
Therapy of benign and malignant thyroid diseases with radioiodine (I-131)
Principal indications
Treatment of hyperthyroidism (M. Basedow, uni- or multifocal autonomies, and nontoxic multi-nodular smear) and differentiated thyroid cancer.
Treatment information
Treatment consists of administration of I-131 in capsules (possible additional mode of administration with liquid formula). This treatment is carried out in a radio-protected inpatient or outpatient setting depending on the I-131 activity used.
Radioreceptor therapy of NET neuroendocrine tumors (PRRT - Lutathera®)
Principal indications
Treatment of inoperable well-differentiated metastatic neuroendocrine tumors. Spread of disease evidenced by morphologic and/or functional imaging. Extent of disease such that the patient is inoperable. Symptoms unmanageable with other medications (especially dehydration, diarrhea, flushing, abdominal pain). PRRT as neo-adjuvant therapy (bridge to surgery).
Treatment information
Treatment consists of 1 ev infusion every 6 to 8 weeks for 4 cycles. This treatment is carried out in a 3-day radio-protected inpatient setting.
Radioreceptor therapy of metastatic prostate tumors (177Lu-PSMA)
Principal indications
Treatment of metastatic prostate tumors expressing prostate membrane-specific antigen. Spread of disease evidenced by morpho-functional imaging (PET-PSMA). Non-responder patient to further therapeutic lines. Disease control.
Treatment information.
Treatment consists of 1 ev infusion every 6 to 8 weeks for 4 to 6 cycles. This treatment is performed in a 3-day radio-protected inpatient setting.
Radiometabolic therapy of painful bone metastases (Quadramet®, Xofigo®)
Principal indications
Treatment of metastatic bone disease in patients with multiple painful skeletal metastases that pick up on bone scintigraphy.
Treatment information with Alpha emitting (Xofigo).
This drug is administered intravenously for a total of six cycles at four-week intervals. Slow infusion preceded by labor controls. This treatment is carried out on an outpatient basis.
Information on treatment with beta emitters (Quadramet).
This drug is administered intravenously with a single administration by slow injection preceded by labor controls. This treatment is carried out on an outpatient basis (the patient will remain under observation at the hospital facility for about 5 hours at the end of which he or she will undergo scintigraphic investigation).
Radio-immuno-therapy
Principal indications.
Monoclonal antibody therapy for the treatment of follicular B-cell lymphoma.
Treatment information
The treatment consists of two sessions, spaced about one week apart, in which first Rituximab and then Ibritumimab are administered. This treatment is carried out on an outpatient basis.
Selective Internal Radiotherapy (SIRT)
Principal indications.
Local treatment of inoperable liver metastases and/or primary liver cancer by microspheres containing the radiopharmaceutical Y-90.
Treatment information
Needed multidisciplinary approach (nuclear physician, interventional radiologist, oncologist, medical physicist) and preliminary angioscintigraphic study to assess treatment feasibility and treatment planning. The drug is administered intra-arterially. After administration he/she will remain under observation and perform PET/CT imaging to assess the adequate distribution of the radiopharmaceutical in the liver. This treatment can take place on an outpatient or inpatient routine basis.
Radiosinoviortesis (RSO)
Principal indications.
Effective therapeutic procedure in the treatment of joint inflammatory processes.
Procedure
Prior to treatment, morphologic and functional imaging (triphasic bone scintigraphy) of the joints is required to assess soft tissue status and the degree of inflammation activity. The radiopharmaceutical (Y-90) is injected intrarticularly. After treatment, the joint is immobilized for three days. This treatment is carried out on an outpatient basis.
The English version of this page was created with the aid of automatic translation tools and may contain errors and omissions.
The original version is the page in Italian.
