Radionuclide therapy

Radionuclide therapy uses radioactive isotopes (radionuclides), administered either orally or intravenously, to deliver highly targeted therapy for a range of disorders, enabling the delivery of a high dose to the target, while minimising normal-tissue toxicity.

Radionuclide therapy, also known as isotope therapy or more recently molecular therapy is used to treat a range of cancers, as well as some non-cancerous diseases.

The field is continually expanding and therapies include:

Of the oldest and most established therapies, radioiodine is used for the treatment of thyroid cancer, as well as a range of benign thyroid diseases. These treatments are well established and have a high success rate. 

Developments in radionuclide therapy led to the use of radionuclides attached to receptors that seek out specific cancerous cells, such as in peptide therapy.

The production of microspheres, small resin spheres that contain hundreds of radionuclide particles, created a ‘brachytherapy’ style radionuclide treatment for secondary liver cancer. The nature of the treatment results in a high dose to the cancer with minimal cost to the liver function. 

In addition to traditional therapies such as strontium-89 (Metastron®) and samarium-153 (Quadramet®), radium-223 (Xofigo®) is now available for the treatment of bone metastases. The simultaneous treatment of multiple sites in a single injection and the proven survival benefit gives an alternative to the traditional palliative treatments such as radiotherapy.

ZEVALIN® (ibritumomab tiuxetan) injection can selectively target and destroy cancerous cells and is widely used for treatment of non-Hodgkin’s lymphoma (NHL).

Other non-cancerous therapies include:

Hyperthyroidism (overactive thyroid) is where the thyroid produces too much thyroxine. It can lead to weight loss, heat intolerance, anxiety, and sore and gritty eyes. It can be successfully treated using radioiodine which ablates (destroys) part of the thyroid tissue, thus reducing the thyroid activity. 

Colloidal yttrium-90 is often used in the management of rheumatoid arthritis (RA). When anti-inflammatory treatments have proved ineffective, treatment of the soft tissue part around the joint (the synovium) is often necessary. Radiosynovectomy with yttrium-90 colloid offers the option of a local, minimally invasive treatment and in many cases, relieve pain and restore the quality of life.