Targeted Radionuclide Therapy
Radiation oncologists at the University of Wisconsin Carbone Cancer Center work together with doctors who specialize in different medical areas to provide treatment that is individualized and well-coordinated.
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Certain types of cancers may be treated with radioactive sources attached to drugs or beads. The radioactive substance is injected into the bloodstream. Treatment may be given in the Radiation Oncology Clinic or by Interventional Radiology. Your UW Health radiation oncologist will discuss your condition and make recommendations for your care.
Types of Targeted Radionuclide Therapies
TheraSphere® is an outpatient treatment that is done in the Interventional Radiology Clinic. The treatment involves injecting tiny radioactive glass beads (TheraSpheres®) into the liver arteries (the blood vessels that bring oxygen to the liver).
The TheraSpheres® travel through the blood vessels until they lodge into the smaller blood vessels of the liver tumor. The beads stay there and give off radiation that destroys the cancer cells with little injury to the healthy liver. After 3 days, the beads lose their radioactivity. There are special radiation precautions to follow for the first 3 days after the procedure.
A samarium treatment (trade name Quadramet®) is a type of radiation treatment. It is a radiopharmaceutical - a drug that is partly radioactive. The radioactive material in the samarium treatment goes into cancer cells in bones via the bloodstream. It does not go into healthy bones or tissues. Samarium can reach cancer cells in bones throughout the body.
A samarium treatment is given during a 2-3 hour clinic appointment. At the start of the appointment, an IV is put into a vein in your hand or arm. IV fluids are then given. This is done to ensure that you are not too “dry.” The samarium is then given. It is injected into the IV, over 1-2 minutes, by the doctor. Medical physicists are present to monitor the injection of the drug. More IV fluids are then given. After the IV fluids are in, the IV catheter is taken out.
Leftover drug is passed out of the body via the urine. A patient getting samarium must pass urine into a clinic toilet before leaving. After this they are allowed to go home. At home, after urinating, you will need to double flush the toilet for the next 24 hours. You should use good hand washing during this time. It takes about 12 hours for leftover radiation from the treatment to be cleared from your body.
Xofigo is a radioisotope used to improve survival in patients with bone metastases from advanced cancer. When injected in a vein, it naturally concentrates in areas of the bone that have been disrupted by cancer cells that have spread to the bone and are growing (bone metastases). Clinical trials testing this agent in prostate cancer patients with bone metastases produced not only relief from bone pain cause by metastases, but also provided longer survival compared to placebo.
Xofigo has received marketing approval by the United States FDA as a treatment for hormone-resistant prostate cancer (CRPC) with bone metastases and is expected to be approved in the future for bone metastases stemming from other cancers as well.
Xofigo has an advantage over other bone metastasis-seeking radiolabeled agents in that its radiation is released mostly in the form of alpha rays, which are very effective in killing cancer cells in the bone, but only travel a very short distance, producing less damage to the nearby bone marrow and resulting less inhibition of the marrow’s production of white blood cells and platelets.