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Dosimetric Model for Antibody Targeted Radionuclide Therapy of Tumor Cells in Cerebrospinal Fluid¹

Department of Clinical Physics and Bioengineering and Radiation Oncology, University of Glasgow, Beatson Oncology Center, Western Infirmary, Glasgow, Scotland

Although encouraging results have been obtained using systemic radioimmunotherapy in the treatment of cancer, it is likely that regional applications may prove more effective. One such strategy is the treatment of central nervous system leukemia in children by intrathecal instillation of targeting or nontargeting ß particle emitting radionuclide carriers. The ß particle dosimetry of the spine is assessed, assuming that the spinal cord and the cerebrospinal fluid compartment can be adequately represented by a cylindrical annulus. The radionuclides investigated were ⁹⁰Y, ¹³¹I, ⁶⁷Cu, and ¹⁹⁹Au. It is shown that the radiation dose to the cord can be significantly reduced using short range ß particle emitters and that there is little advantage in using targeting carriers with these radionuclides. ¹⁹⁹Au and ⁶⁷Cu also have the advantage of having a suitable emission for imaging, permitting pretherapy imaging and dosimetric calculations to be undertaken prior to therapy. If these methods prove successful, it may be possible to replace the external beam component used in the treatment of central nervous system leukemia in children by intrathecal radionuclide therapy, thus reducing or avoiding side effects such as growth and intellectual impairment.