ARRS: How to manage the side effects of radiopharmaceuticals

Three clinical issues that may arise with theranostics treatments will require special provisions, including spot imaging, according to insights shared during the 124th annual meeting of the American Roentgen Ray Society (ARRS) in Boston. Theranostics treatments are used with increasing frequency now since the approvals and expansions of Lutathera (lutetium-177 [Lu-177]) DOTATATE, a radiopharmaceutical for neuroendrocrine tumors (NETs) and Pluvicto, Lu-177 PSMA-617, for prostate cancer. Though common but not serious side effects, sialoadenitis (inflammation of the salivary gland) and xerostomia (dry mouth) can occur with prostate-specific membrane antigen (PSMA) treatments. On the other hand, two serious side effects occurring less frequently are carcinoid crisis with DOTATATE therapies, and extravasations with any intravenous (IV) radiopharmaceutical therapies, explained Erica Cohen Major, DO, a nuclear medicine specialist and assistant chief of nuclear medicine at Edward Hines VA Hospital near Chicago. "We're seeing patients in rapid sequence, multiple times a week, maybe even multiple times a day; they're coming back every three to six weeks for labs, and we're having to make clinical decisions about things that we didn't even think about before," Major said. Extravasations Extravasations, in particular, are of interest to the U.S. Nuclear Regulatory Commission, Major noted, saying that risks of radiation injury to the skin from radioactive IV treatments could be sign...
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