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放射免疫治疗(radioimmunotherapy,RIT)属于内照射治疗,可以用较少的单克隆抗体耦联放射性核素,在肿瘤局部产生足够的电离辐射生物学效应,达到高效低毒的治疗效果。B细胞淋巴瘤有较高的复发比例,其CD20抗原表达率达90%以上,且不易从细胞膜上脱落,因此131I-利妥昔单抗CD20是B细胞淋巴瘤放免治疗的最佳靶点。目前已有数个放免治疗的药物,如:131I-托西莫单抗(131I-tositumomab)、131I-Rituximab、90Y-替坦异贝莫单抗(90Y-ibritumomabtiuxetan)等,用于B细胞淋巴瘤的临床治疗,它们具有各自的优缺点。使用结果表明:肿瘤部位的高吸收剂量保证了治疗的有效性,其对非靶器官的照射剂量是安全的。最主要的副反应包括:血小板减少症、中性粒细胞减少症、胃肠道反应及甲状腺功能减低症。在取得满意结果的同时,B细胞淋巴瘤放免治疗仍存在许多问题,人们正致力于更进一步的研究解决此类问题,以取得更好的治疗效果。
Radiotherapy (radioimmunotherapy, RIT) belongs to the internal radiation therapy, can use fewer monoclonal antibodies conjugated radionuclide, in the tumor local enough biological effects of ionizing radiation, to achieve the effect of high efficiency and low toxicity. B-cell lymphoma has a higher recurrence rate, the CD20 antigen expression rate of more than 90%, and is not easy to fall off from the cell membrane, so 131I-rituximab CD20 B cell lymphoma is the best target for radiotherapy. There are several radiopharmaceuticals currently available, such as 131I-tositumomab, 131I-Rituximab, 90Y-ibritumomabtiuxetan and the like, for use in B-cell lymphoma The clinical treatment, they have their own advantages and disadvantages. The results show that the highly absorbed dose at the tumor site ensures the effectiveness of the treatment and is safe for non-target organ irradiation doses. The main side effects include: thrombocytopenia, neutropenia, gastrointestinal reactions and hypothyroidism. While satisfactory results are obtained, there are still many problems with radioimmunotherapy of B-cell lymphoma. People are working on further research to solve such problems in order to achieve better therapeutic effects.