Radiation Physics

PV QA 3 - Poster Viewing Q&A 3

TU_6_3174 - Establishing a Lu-177 Dotatate Therapy Program

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Establishing a Lu-177 Dotatate Therapy Program
W. Snyder1,2, K. Harpool1,2, J. W. Swanson1,2, P. Schantz1,2, A. Phan2, J. S. Dick1,2, and S. X. Cavanaugh2; 1Landauer Medical Physics, Glenwood, IL, 2Cancer Treatment Centers of America, Newnan, GA

Purpose/Objective(s): To establish a procedure and protocol for a new Lu-177 dotatate therapy program.

Materials/Methods: NCR 8.39 provides guidelines for releasing patients who have been administered a radioactive source. Since Lutetium 177 (Lu-177) is not listed, a calculation-based protocol is needed for compliance with NRC regulation. Equation 1 from NRC 8.39 was used to establish the release criteria. Patients are released with readings below 8 mrem/hr at 1 meter and also receive instructions prior to being released. Additional procedures for handling the radioactive byproduct were also implemented.

Results: To absorb radioactive contamination, the rooms, pumps, toilet, and restroom floor were covered with absorbent pads. The patient was given his/her own restroom, and instructions to flush 2-3 times each use. An amino acid infusion was given (containing L-lysine and L-arginine) for 30-45 minutes at a rate of 250 ml/hr. The flow rate of the lutetium dotatate began at 50 ml/hr, increased to 150 ml/hr, and then increased again up to 250 ml/hr, based on patient tolerance. The Lu-177 infusion took 45-60 minutes and the amino acids continued until the entire 1L bag was delivered. The total infusion time is 4-5 hours. The patient had no outside contact during the time of infusion. After infusion is complete, the patient is surveyed at 1 meter and is eligible for release to the public with a survey reading of less than 8 mrem/hr with special instructions. Lu-177m is a bi-product of the Lu-177 production, and decays with a half-life of 160 days. Therefore, excess lutetium and any soiled linens were stored in a separate shielded waste container and picked up by a nuclear waste disposal company. A total of 6 treatments have been treated to date. All had a 200 mCi prescription, and the amount of Lu-177 infused was from 191.67-199.9 (mean 195.8 mCi). Total times from all 6 treatments ranged from 4.08 hours to 6.42 hours (mean 5.4 hours). Final survey readings of patients at 1 m were from 1.7 mrem/hr to 3 mrem/hr (mean 2.43 mrem/hr).

Conclusion: These guidelines outline considerations necessary for implantation of a Lu-177 Dotatate therapy program.

Author Disclosure: W. Snyder: None. K. Harpool: None. J.W. Swanson: None. A. Phan: None. S.X. Cavanaugh: None.

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