What is Therapeutic Nuclear Medicine?
Therapeutic nuclear medicine, also known as radionuclide therapy or theranostics, involves the use of radioactive substances to selectively target and destroy diseased tissues while minimizing damage to surrounding healthy organs.
These therapies are based on the principle of delivering radiation directly to diseased cells using biologically targeted radiopharmaceuticals.
Types of Radionuclide Therapies
Thyroid Cancer and Thyroid Disorders
Radioiodine Therapy (I-131) for Thyroid Cancer
Used for ablation of residual thyroid tissue and treatment of metastatic differentiated thyroid carcinoma.
Radioiodine Therapy (I-131) for Hyperthyroidism
Used for definitive treatment of Graves' disease and toxic nodular goitre.
Neuroendocrine Tumor Therapies
Lu-177 DOTATATE / DOTATOC Therapy (PRRT)
Used for treatment of well-differentiated neuroendocrine tumors expressing somatostatin receptors.
Y-90 DOTATOC Therapy
Used in selected cases of advanced neuroendocrine tumors.
Prostate Cancer Therapies
Lu-177 PSMA Therapy
Used in metastatic castration-resistant prostate cancer with PSMA expression.
Ac-225 PSMA Therapy (Alpha Therapy)
Used in selected advanced prostate cancer patients resistant to other treatments.
Bone Metastases Pain Palliation
Sr-89 Therapy
Used for pain relief in skeletal metastases.
Sm-153 EDTMP Therapy
Used for palliation of painful bone metastases.
Lymphoma and Hematological Malignancies
Y-90 Ibritumomab Tiuxetan Radioimmunotherapy
Used in selected B-cell non-Hodgkin's lymphoma cases.
I-131 Tositumomab Therapy
Used in specific lymphoma patients (limited availability).
Joint Disorders (Radiosynovectomy)
Y-90 Radiosynovectomy
Used for large joints in chronic inflammatory arthritis.
Re-186 Radiosynovectomy
Used for medium-sized joints.
Er-169 Radiosynovectomy
Used for small joint disorders.
Pediatric and Rare Indications
I-131 MIBG Therapy
Used in neuroblastoma and pheochromocytoma.
Lu-177 / Y-90 MIBG Therapy
Used in selected neuroendocrine malignancies.
Patient Selection and Safety
- Therapies are offered only after thorough clinical evaluation
- Appropriate molecular imaging is used to confirm target expression
- Dosimetry and radiation safety protocols are strictly followed
- Patients are monitored before, during, and after therapy
Benefits of Radionuclide Therapy
- Targeted treatment with minimal systemic toxicity
- Effective in advanced and refractory cancers
- Personalized treatment approach
- Can be combined with chemotherapy, surgery, and radiation
Conclusion
Therapeutic nuclear medicine represents the future of personalized cancer care. By combining molecular imaging with targeted therapy, radionuclide treatments offer effective and safe options for patients who may not respond to conventional therapies.
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