Article Figures & Data
Figures
- FIGURE 1.
Duration of response. (Reprinted with permission of (2).)
- FIGURE 2.
Steps in tositumomab and 131I-tositumomab therapeutic regimen.
- FIGURE 3.
Expected biodistribution showing blood-pool activity in heart and major vessels on first scan (A) decreasing in intensity on second scan (B) and third scan (C) for patient with NHL. Moderate uptake in liver and spleen on first scan progressively diminishes in intensity on second and third scans. Views are anterior.
- FIGURE 4.
Expected biodistribution showing blood-pool activity in heart and major vessels on first scan (A) decreasing in intensity on second scan (B) and third scan (C) for patient with retroperitoneal adenopathy. Moderate uptake in liver and spleen on first scan progressively diminishes in intensity on second and third scans. Tumor uptake is seen as 2 focal areas of moderate uptake in upper to middle abdomen, best seen on second scan, corresponding to retroperitoneal adenopathy seen on CT scan. “Butterfly”-shaped uptake seen in neck on third scan represents thyroid uptake. Views are anterior.
- FIGURE 5.
Expected biodistribution for patient with lymphomatous nodules. Multiple areas of various sizes, configurations, and intensities are seen in right upper chest wall laterally, epigastric region just to right of midline, lower right abdomen laterally, bilateral inguinal regions, and proximal right thigh on second scan (B). Some of these areas persist on third scan (C). These areas represent cutaneous lymphomatous nodules. Focal intense uptake is first seen in left upper abdomen on third scan, most likely representing activity in fundus of stomach. Views are anterior.
- FIGURE 6.
Example of TBRT after dosimetric administration of tositumomab and 131I-tositumomab. Best-fit line for 2 assessment time points and 100% initial time point are shown.
Tables
- TABLE 1
Roles of Health Care Team Members During Administration of Tositumomab and 131I-Tositumomab Therapeutic Regimen
Responsible Party Role Hematologist or oncologist Radiation oncologist Nuclear medicine physician Nuclear medicine technologist Radiation safety officer Oncology nurse Nuclear pharmacist Hospital pharmacist Medical physicist Review radioactive material license X X X Identify and refer patients X Prescribe therapy X X Educate patients X X X X X X X X X Place order with BSC X Report platelet counts for dose calculation X Prescribe thyroid block X X X Prescribe premedications X Receive packaging and prepare doses X Administer cold infusion X X X X Monitor patient X X X X X Administer hot infusion X X X Report adverse events X X X X X X X X X Perform quality control procedures and acquire images X Calculate estimated dose (after second scan) X X X X Calculate therapeutic dose X X X X Send completed dosimetry worksheets to nuclear pharmacy X X Report final dose calculation to BSC X X Determine when patient can be released X X X Instruct patient regarding radiation safety precautions X X X X X Perform patient follow-up X - TABLE 2
Prescribed Dosage for Each Step of Tositumomab and 131I-Tositumomab Therapeutic Regimen
Dose Tositumomab 131I Tositumomab Dosimetric 450 mg 185 MBq (5 mCi) Therapeutic 450 mg 75 cGy (platelet count > 150,000/mm3) 65 cGy (platelet count > 100,000/mm3 and < 150,000/mm3) Regimen is not indicated for patients with platelet count < 100,000/mm3
