Radiation nephropathy after radiotherapy in metastatic medullary thyroid carcinoma

Abstract

Moll et al. w1x recently published a case report on the development of thrombotic microangiopathy after irradiation in ovarian malignancy. We would like to report our case of radiation nephropathy developing after`internal' radiotherapy in a female patient with metastatic medullary carcinoma. Radiation nephritis is an in¯ammatory and degenerative disease of the kidneys after exposure to radioactive substances or body irradiation. Technical development, increasing knowledge of the adverse effects of radiation, and implementation of preventive measures have reduced its incidence during the last decades. However, recent therapeutic advances in oncology (such as administration of radiometal-labelled peptide conjugates or combined high dose chemotherapy and radiation therapy in stem cell transplantation) increase nephrotoxicity. As demonstrated in our patient, the treatment with radioactive substances speci®cally bound to tumour-selective cell receptors (i.e. somatostatin receptors in metastatic medullary thyroid carcinoma) caused thrombotic microangiopathy that led to end-stage radiation nephropathy after 8 months. Case. A 63-year-old Caucasian female patient was admitted to our hospital in May 1999 for progressive weakness and newly diagnosed arterial hypertension. Blood tests revealed normochromic, normocytic anaemia (haemoglobin 8.0 gudl

Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine

“…In the aforementioned PRRT study with [ 111 In-DTPA 0 ]octreotide [5], no acute nephrotoxicity was noticed, confirming findings in rat experiments [11]. In contrast, recent reports have shown both acute and late renal side-effects in studies on PRRT with [ 90 Y-DOTA 0 ,Tyr 3 ]octreotide [6,12,13,14]. A cumulative dose of [ 90 Y-DOTA 0 ,Tyr 3 ]octreotide of more than 7,400 MBq/m 2 , without renal protection, may be a risk factor for renal toxicity [6], whereas lower doses may cause late-onset renal insufficiency [12].…”

“…In a dose-escalation animal study, high cumulative doses of [ 111 In-DOTA 0 ,Tyr 3 ]octreotide did not cause microscopic damage [11]. Furthermore, several reports have been published on nephropathy after PRRT with [ 90 Y-DOTA 0 ,Tyr 3 ]octreotide [6,12,13,14], but these reports did not provide data on renal absorbed doses. No renal toxicity of PRRT with [ 111 In-DTPA 0 ]octreotide was found [5].…”

Pathological Evaluation and Biochemical Characterization of Peptide Receptors Other Than Somatostatin Receptors as Potential Tumor Targets for Radionuclide Diagnosis and Therapy

“…33,[52][53][54] The results suggested that a cumulative dose of 90 Y-DOTATOC of more than 7.4 GBq/m 2 might be a risk factor for renal insufficiency.…”

Peptide receptor radionuclide therapy

“…33, [52][53][54] The results suggested that a cumulative dose of 90 Y-DOTATOC of more than 7.4 GBq/m 2 might be a risk factor for renal insufficiency. 33 However, some years later, a case report of a patient who developed late-onset renal insufficiency with a total cumulative dose of less than 7.4 GBq/m 2 indicated that even less radiation can cause renal damage at a later time point.…”