The Status and Prospects of Radiopharmaceutical Research for Targeted Radiotherapy in Taiwan Shyh-Jen Wang1, Gann Ting2 1
Taichung Veterans General Hospital, Taichung, Taiwan Institute of Nuclear Energy Research, Lung-Tan, Taiwan
2
Therapeutic nuclear medicine has grown rapidly as a treatment modality in oncology in last decade. A variety of specific tumor-seeking radiopharmaceuticals have been commercialized for radiotherapy. However, most of these therapeutic radiopharmaceuticals are not applied to patients clinically in Taiwan because of difficulty in importing these drugs from other countries and their high expense. Therefore, the Institute of Nuclear
Introduction In last decade, therapeutic nuclear medicine has grown rapidly as a treatment modality in oncology. Many different specif ic tumor-seeking radiopharmaceuticals have been developed for treatment. However, the import of these radiopharmaceuticals is difficult and expensive. Certain therapeutic radiopharmaceuticals are being developed independently in Taiwan.
Energy Research (INER) in Taiwan has been putting their efforts on developing these therapeutic radiopharmaceuticals and several kinds of therapeutic radiopharmaceuticals have been developed successfully in the past few years.
90
Y-lipiodol,
188
Re-lipiodol and
188
Re-
microsphere are developed for the therapy of hepatoma, 188
188
Re-HEDP for metastatic bone pain and
Re-sulfur colloid for malignant ascites. Pre-clinical
studies of these radiopharmaceuticals are being carried out and clinical trials will be conducted soon. Key words: radiotherapy, radiopharmaceutical, Lipiodol,
188
Re-Lipiodol,
188
Re-microsphere,
188
90
Y-
Re-HEDP,
188
Re-sulfur colloid
Ann Nucl Med Sci 2002;15:195-200
Received 11/16/2001; accepted 6/2/2002. For correspondence or reprints contact: Shyh-Jen Wang, M.D., Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Section 3, Taichung Harbor Road, Taichung 407, Taiwan, R.O.C., Tel: (886)4-23741349, Fax: (886)4-23741348, E-mail: sjwang@vghtc.vghtc.gov.tw
90
Y-Lipiodol Hepatoma is one of the most common malignant tumors in the world, especially prevalent in southeastern Asia, Japan and sub-Saharan Africa. In Taiwan, hepatoma is the most common cancer in males, and the sixth most common in females. Hepatoma is often found at an advanced stage when surgery is difficult or impossible in most patients. Treatment of inoperable hepatoma with systemic cytotoxic chemotherapy has not been successful, with little or no improvement in the survival rate. Carriers of therapeutic agents that treat hepatoma effectively, without damage to normal tissue, are currently under investigation. One such carrier is Lipiodol, an ethyl ester of poppy seed oil fatty acids. It has been found to be selectively retained in hepatoma [1]. In addition, Lipiodol is used to detect the existence of hepatoma [2], and is used as an embolic material in transhepatic arterial embolization [3,4]. 131 I-Lipiodol has also been successfully developed and tested for the treatment of hepatoma [5,6]. Furthermore, some authors have suggested that 90Y is a better radiotherapeutic candidate than 131I. 90Y has several advantages over 131I, including a shorter half-life which is more suitable for therapy, lack of gamma ray emission, a longer beta energy range