Dosimetrie bei der SIRT

Zusammenfassung

Die „Selektive interne Radiotherapie“ (SIRT) oder „transarterielle Radioembolisation“ (TARE) mit Yttrium-90-Mikrosphären ist eine Erfolg versprechende Therapie für maligne Lebertumoren. Dosimetrische, interventionelle, onkologische und hepatologische Aspekte müssen in eine optimale Therapieplanung einbezogen werden. Die produktspezifischen dosimetrischen Berechnungen für die beiden kommerziellen Mikrosphärenpräparate werden verglichen und zu den mittleren Dosen in Tumor und Leber in Beziehung gesetzt. Scheinbare Diskrepanzen zwischen der Dosis-Wirkungs-Beziehung für Y-90-Mikrosphären und die perkutane Strahlentherapie werden im Lichte strahlenbiologischer Erkenntnisse diskutiert.

Abstract

Dosimtery is only one aspect of treatment planning for “Selective internal radiotherapy” (SIRT) or „transarterial radioembolization“ (TARE) with Yttrium-90 Microspheres is an emerging palliative therapy for malignant hepatoma. Dosimetric considerations, together with interventional, oncological and hepatological aspects need to be considered for optimal treatment stratification. The product-specific dosimetric calculations for 2 commercially available microsphere products are compared and set in relation to the average doses to liver and tumor. Ostensible discrepancies between the dose-response of Y-90-microspheres and external beam radiation therapy are discussed in the context of radiobiological concepts.

Schlüsselwörter

Yttrium-90-Mikrosphären - Dosimetrie - Normalgewebstoleranz - biologisch äquivalente Dosis - inhomogene Dosisverteilung - Strahlenbiologie

Key words

Yttrium-90 microspheres - dosimetry - normal tissue tolerance - biologically equivalent dose - inhomogeneous dose distribution - radiation biology

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