CD20阳性B细胞NHL~(131)I-美罗华放射免疫治疗剂量个体化的临床初步研究

The Primary Clinical Study on Individual Radioimmunotherapy Protocol With ~(131)I-rituximab for CD20 PositiveB Cell Non-Hodgkin's Lymphoma

  • 摘要: 本研究旨在观察不同个体间131I-美罗华全身清除速率的差异,并拟定131I-美罗华放射免疫治疗个体化治疗剂量。选取CD20阳性B细胞NHL患者13例,于不同时相行全身平面显像,监测131I-美罗华的全身分布和清除情况,绘制时间-放射性曲线得到全身清除速率常数(λ),计算全身有效半清除时间Teff,采用医用内照射吸收剂量(Medical Internal Radiation Dosimetry,MIRD)法求得示踪剂量水平的全身辐射吸收剂量,并参照体重为70 kg的标准人体模型131I-美罗华全身最大耐受剂量为75 cGy,求得个体化的最大允许注射活度。结果显示:13例患者Teff为58.73~177.69 h(96.87±30.58 h),似呈正态分布;最大允许注射活度为1.14~2.95 GBq,其分布无明显规律。根据求得的最大允许注射活度试行治疗其中1例病人,其病情获得了部分缓解。

     

    Abstract: The study is to observe the effective half life of 131I -rituximab in different patients and to establish a individual radioimunotherapy dosage. The biologic distribution and clearances of 131I -rituximab in 13 CD20 positive B cell NHL(non-Hodgkin's lymphoma, NHL) patients are detected by plane scans, and the whole-body counts are collected for drawing time-radioactivity curve, based on which the whole body clearance rate(A) and the whole-body effective half life(Teff)of each patientareare obtained. And then whole-body radiation dose in imaging dose level could be calculated by MIRD (Medical Internal Radiation Dosimetry, MIRD)formula. Finally, by making 75 cGy at the maximally tolerated whole-body radiation dose for a 70-kilogram-weight man as a reference, the maximally individual administered radioactivity could be achieved. For all of the thirteen patients, the range of Teff is 58. 73-177. 69 h(96. 87±30. 58 h), whose distribution seems to be normal, and Teff of most patients is 90-120 h. The range of maximally individual administered radioactivity is 1. 14-2. 95 GBq, whose distribution is irregular. One of these patients is treated with this method and demonstrates a partial response.

     

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