Radiation safety with Yttrium 90 ibritumomab tiuxetan (Zevalin) radioimmunotherapy

Radioimmunotherapy as the first line of treatment in non-Hodgkin lymphoma

Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy. The estimated deaths and new cases of NHL in the USA in 2018 have reached 19,910 and 74,680, respectively, with 5-year survival rate of 71%. Therapeutic interventions for NHL consist of chemotherapy, radiation therapy and immunotherapy. Radioimmunotherapy (RIT) is a potential alternative treatment for NHL that is currently used in different lines of treatment. Studies show that nuclear medicine physicians and radiation oncologists are not yet certain about the proper line for administration of RIT. Herein, we have reviewed the efficiency and toxicity of RIT as the first line of treatment, and discussed potential novel indications, and strategies such as modifying induction therapy and using rituximab maintenance to optimize the efficiency of RIT as the first line of treatment. Our review indicates that it is more logical to postpone conventional therapies to the second or third lines of treatment instead of RIT.

Radioimmunotherapy for non-Hodgkin's lymphoma

OBJECTIVES

To describe the rationale for radioimmunotherapy as a treatment of non-Hodgkin's lymphoma. To present the similarities and differences in the two radioimmunotherapies and the nursing implications in caring for patients receiving these agents.

DATA SOURCES

Published literature and review of published clinical trials.

CONCLUSION

Radiolabeled monoclonal antibodies bind to specific antigens and provide a means of targeting tumor cells with cytotoxic radioactivity. The infusion of radiolabeled monoclonal antibodies requires an understanding of antibody therapy, radiation therapy, and principles of time, distance, and shielding.

IMPLICATIONS FOR NURSING PRACTICE

As the use of radioimmunotherapy grows, nurses must be aware of the background for, logistics of, and follow-up required for patients receiving this form of radiation treatment.