Patient organ and effective dose estimation in radionuclide therapy with ²²³Ra -dichloride

Radionuclide therapy with 223Ra-dichloride is used to treat bone metastases and to improve the quality of life of patients with metastatic castration-resistant prostate cancer. At the present time there is no reliable data on the biodistribution of the 223Ra-dichloride in the patient body. The aim of this study was to assess absorbed, equivalent doses in radiosensitive organs and tissues and effective dose from internal exposure for patients with metastatic castration-resistant prostate cancer treated with 223Ra-dichloride. Internal doses from 223Ra-dichloride were calculated for a chamber model specific for patients with metastatic castration-resistant prostate cancer. This model consists of 8 chambers (blood plasma, two chambers describing bone tissue, small intestine, upper large intestine, lower large intestine, feces and the rest of the body). Time-integrated activities were calculated using the SAAM II v2.3 software. The IDAC-Dose 2.1 software was used to calculate the absorbed doses. The highest absorbed doses in organs and equivalent doses were determined for the bone surface and red bone marrow. The absorbed dose from a-radiation in the bone surface for a set of six therapeutic procedures with 223Ra-dichloride was estimated as 1 Gy; in the red bone marrow — 0.14 Gy. However, the approach used does not specifically consider accumulation of the radiopharmaceutical in metastases, which can lead to a significant overestimation of the absorbed dose in the healthy part of the bone surface and red bone marrow