{"id":1309,"date":"2018-12-18T11:35:11","date_gmt":"2018-12-18T17:35:11","guid":{"rendered":"https:\/\/www.crpa-acrp-bulletin.ca\/?p=1309"},"modified":"2020-02-18T20:55:12","modified_gmt":"2020-02-19T02:55:12","slug":"assessing-dose-administration-of-lu-177-dotatate-therapy-quantifying-the-residual-dose-second-instalment","status":"publish","type":"post","link":"https:\/\/www.crpa-acrp-bulletin.ca\/fr\/2018\/12\/18\/assessing-dose-administration-of-lu-177-dotatate-therapy-quantifying-the-residual-dose-second-instalment\/","title":{"rendered":"Assessing Dose Administration of Lu-177 Dotatate Therapy: Quantifying the Residual Dose, Second Instalment"},"content":{"rendered":"
\n

R\u00e9sum\u00e9<\/h4>\n

Au cours d\u2019une radioth\u00e9rapie, le dotatate marqu\u00e9 au Lu-177 est typiquement dilu\u00e9 dans une poche de s\u00e9rum physiologique, puis infus\u00e9 chez le patient par intraveineuse. Une fois administr\u00e9es, la poche de s\u00e9rum physiologique et l\u2019intraveineuse sont rinc\u00e9es pour s\u2019assurer que la dose r\u00e9siduelle soit administr\u00e9e au patient. Toutefois, changer le sac de perfusion dans une seconde poche de s\u00e9rum physiologique augmente le risque de contamination. Christian Detlef Raharja voulait savoir si le fait de rincer l\u2019intraveineuse apr\u00e8s la radioth\u00e9rapie au Lu-177 am\u00e9liore l\u2019administration d\u2019une dose ou si le fait de jeter l\u2019intraveineuse et la poche de s\u00e9rum physiologique constituerait une meilleure pratique.<\/p>\n

Cet article sera pr\u00e9sent\u00e9 en trois segments. Dans le premier segment, l\u2019auteur d\u00e9crivait sa question et son hypoth\u00e8se de recherche. Dans ce deuxi\u00e8me segment, il en d\u00e9crit les proc\u00e9dures et \u00e9valuations. Enfin, le segment final discutera des r\u00e9sultats de sa recherche.<\/p>\n<\/div><\/div><\/div>\n

by Christian Detlef Raharja
\nWith contributions by Edward Sun, Judy Gabrys, and Rebecca Wong
\nThe Michener Institute, University of Toronto<\/p>\n

Background<\/h1>\n

When conducting Lu-177 therapy, the Lu-177 dotatate is typically diluted in a saline bag and then infused through an intravenous (IV) line to the patient. After administration, the saline bag and IV line are flushed to ensure the residual dose is administered to the patient. However, changing the infused bag to the second saline bag increases the risk of contamination. The author wanted to know if flushing the line after Lu-177 therapy improves dose administration or if discarding the line and saline bag would lead to better practice.<\/p>\n

This paper is presented in three instalments. In the first instalment<\/a>, the author described his research question and hypothesis. In this instalment, he will describe the procedures and evaluations.<\/p>\n

Methods<\/h1>\n

Study population<\/h2>\n

This sub-study was conducted at the Princess Margaret Cancer Centre in Toronto, ON, with post-Ga-68-dotatate patients positive for neuroendocrine tumours (NETs). The patients\u2019 workup prior to therapy is shown in Figure 3.<\/p>\n

\"\"
\nFigure 3: <\/strong>Patient\u2019s work-up prior to Lu-177-dotatate therapy.<\/span><\/em>[1<\/a>]\n

The six-month study involved 15 patients and 25 cases (some patients had multiple trials). There were no age or gender restrictions for the therapy itself. Following are the inclusion and exclusion criteria for Lu-177 therapies.<\/p>\n

Table 1:<\/strong> Inclusion and exclusion criteria for Lu-177 therapies.<\/span><\/em>[2<\/a>]\n\n\n\n\n
Inclusion Criteria<\/strong><\/td>\nExclusion Criteria<\/strong><\/td>\n<\/tr>\n
\n
    \n
  • Biopsy-proven NET<\/li>\n
  • Eastern Cooperative Oncology Group (ECOG) performance status \u2264 2\u00a0(used to assess disease progression)<\/li>\n
  • Ki67 index \u2264 30% (cellular marker for proliferation)<\/li>\n
  • Evidence of disease progress through imaging six months prior to study enrolment<\/li>\n
  • Adequate lab parameters within two weeks of therapy<\/li>\n
  • Adequate liver function tests within two weeks of therapy<\/li>\n
  • Willingness to comply with visits, treatment, and laboratory tests<\/li>\n
  • Signed consent form<\/li>\n<\/ul>\n<\/td>\n
\n