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Observational Study
. 2024 Sep;42(9):1031-1037.
doi: 10.1007/s11604-024-01585-5. Epub 2024 May 10.

Maximum tumor diameter and renal function can predict the declining surface dose rate after 177Lu-Dotatate: preliminary results of single institution in Japan

Takashi Ono  1 , Mayumi Ichikawa  2 , Takeo Tanada  3 , Chika Kanezawa  3 , Hiraku Sato  3
Affiliations
Observational Study

Maximum tumor diameter and renal function can predict the declining surface dose rate after 177Lu-Dotatate: preliminary results of single institution in Japan

Takashi Ono et al. Jpn J Radiol. 2024 Sep.

Abstract

Purpose: This study aimed to develop a user-friendly prediction formula for dose rate adjustment after initial 177Lu-Dotatate therapy from a prospective observational study of patients.

Materials and methods: This study included consenting patients in a prospective observational study who underwent their first treatment in four cycles of 177Lu-Dotatate treatment at our hospital between January 2022 and February 2024. All patients received 7.4 GBq of 177Lu-Dotatate. The prediction formula was derived from the regression analysis of tumor-related factors and renal function. Creatinine clearance was estimated using the Cockcroft-Gault equation in this study for renal function.

Results: Among the 13 patients (seven males, six females, median age: 59 years), logarithmically transformed total tumor volume (cc) and maximum tumor diameter (mm) of primary tumors or metastases showed strong correlations (p < 0.001, R2 = 0.897). As such, the maximum tumor diameter was used as the tumor parameter in the prediction formula. Additionally, maximum tumor diameter and creatinine clearance showed strong (p < 0.001, R2 = 0.768) and moderate (p = 0.013, R2 = 445) correlations, respectively, with the ratio of the dose rate 5.5-h post-administration to the dose rate immediately post-administration (%) at 1 m from the body surface. The resulting formula, 51.4 + 0.360 × maximum tumor diameter (mm) - 0.212 × creatinine clearance (ml/min), demonstrated an extremely strong correlation (p < 0.001, R2 = 0.937).

Conclusion: The present study showed that the maximum tumor diameter and renal function affected the declining the dose rate of patients surface after 177Lu-Dotatate, which can inform post-administration dose rate management and potentially facilitate outpatient treatment in Japan.

Keywords: 177Lu-Dotatate; Dose rate; Peptide receptor radionuclide therapy; Renal function; Tumor diameter.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The correlation between maximum tumor diameter and total tumor volume
Fig. 2
Fig. 2
The correlation between maximum tumor diameter and logarithmically transformed numbers total tumor volume
Fig. 3
Fig. 3
The correlation between maximum tumor diameter and the ratio of dose rate 5.5 h after treatment per it just after treatment
Fig. 4
Fig. 4
The correlation between creatinine clearance and the ratio of dose rate 5.5 h after treatment per it just after treatment
See this image and copyright information in PMC

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