ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2019-2-4-35-41ojrdrt-89Research ArticleЯДЕРНАЯ МЕДИЦИНАNUCLEAR MEDICINEДозиметрическое моделирование экстравазального введения терапевтических радиофармпрепаратовDosimetric Modeling of Extravasal Administration of Therapeutic RadiopharmaticalsНаркевичБ. Я.NarkevichB. Ya.

Москва

Moscow

narvik@yandex.ruЛысакЮ. В.LysakYu. V.

Москва

Moscow

РыжовС. А.RyzhovS. A.

Москва

Moscow

Ассоциация медицинских физиков России; Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФРоссияAssociation of Medical Physicists of Russia; N.N. Blokhin National Medical Research Center of OncologyRussian FederationАссоциация медицинских физиков России; ООО «Медскан»РоссияAssociation of Medical Physicists of Russia; LLC “Medskan”Russian FederationАссоциация медицинских физиков России; Научно-практический клинический центр диагностики и телемедицинских технологий Департамента здравоохранения города МосквыРоссияAssociation of Medical Physicists of Russia; Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Department of HealthRussian Federation201930122019243541Copyright © Наркевич Б.Я., Лысак Ю.В., Рыжов С.А., 20192019Наркевич Б.Я., Лысак Ю.В., Рыжов С.А.Narkevich B.Y., Lysak Y.V., Ryzhov S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/89

При радионуклидной терапии онкологических заболеваний существует опасность экстравазального введения значительной активности радиофармпрепарата. Попадание радиофармпрепарата не в просвет локтевой вены, а в окружающие мягкие ткани обусловливает существенное локальное облучение этих тканей короткопробежными бета-частицами, вследствие чего могут возникнуть радиационно- индуцированные поражения кожи той или иной степени тяжести. По консервативному сценарию методом Монте-Карло проведено дозиметрическое моделирование внутреннего облучения дермального слоя кожи после экстравазального введения 4 бета- и бета-гамма-излучающих терапевтических радиофармпрепаратов. Показано, что в зависимости от радиационно-физических характеристик радиофармпрепарата и эффективного времени резорбции очага, образовавшегося после инъекции, поглощенная доза внутреннего облучения кожи варьирует в диапазоне от 0,2 до 182 Гр. В этом диапазоне доз клинические проявления лучевых осложнений могут проявляться от эритемы до лучевого некроза. Представлены рекомендации по предотвращению и подавлению негативных медицинских последствий экстравазальных введений терапевтических радиофармпрепаратов.

With radionuclide therapy of cancer, there is a risk of extravasal administration of significant activity of the radiopharmaceutical. The ingress of the radiopharmaceutical not into the lumen of the ulnar vein, but into the surrounding soft tissues causes a significant local irradiation of these tissues with short-range beta particles, as a result of which radiation-induced skin lesions of one degree or another may occur. According to the conservative scenario, the Monte Carlo method performed dosimetric modeling of the internal irradiation of the dermal layer of the skin after extravasal administration of 4 beta and beta-gamma-emitting therapeutic radiopharmaceuticals. It was shown that, depending on the radiation-physical characteristics of the radiopharmaceutical and the effective time of resorption of the lesion formed after injection, the absorbed dose of internal skin irradiation varies from 0.2 to 182 Gy. In this dose range, clinical manifestations of radiation complications can occur from erythema to radiation necrosis. Recommendations are presented on the prevention and suppression of the negative medical consequences of extravasal administration of therapeutic radiopharmaceuticals.

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The authors declare that there are no conflicts of interest present.