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Selected Publication:
Pirich, C; Pilger, A; Schwameis, E; Germadnik, D; Prüfert, U; Havlik, E; Lang, S; Kvaternik, H; Flores, JA; Angelberger, P; Wanivenhaus, A; Rüdiger, HW; Sinzinger, H.
Radiation synovectomy using 165Dy ferric-hydroxide and oxidative DNA damage in patients with different types of arthritis.
J Nucl Med. 2000; 41(2):250-256
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- Co-authors Med Uni Graz
- Kvaternik Herbert
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- Abstract:
- Radiation synovectomy is an effective treatment for chronic synovitis refractory to pharmacological treatment in patients with rheumatoid or seronegative arthritis. Concerns persist about possible radiation-induced cytogenetic damage after radiation synovectomy leading to recommendations to use this technique only in the elderly. Micronucleus (MN) frequency in lymphocytes and urinary excretion of 8-hydroxy-2'-deoxyguanosine (8OHdG) as an indicator of cellular oxidative DNA base damage are biomarkers of radiation-induced cytogenetic damage. The course of both biomarkers was studied in patients with different types of chronic synovitis undergoing radiation synovectomy with very short-lived Dy-165-ferric-hydroxide (DFH). Methods: Radiation synovectomy of the knee was performed in 13 men and 12 women (mean age, 44 +/- 15 y) using a mean activity of 9.48 +/- 1.65 GBq Dy-165-DFH in 27 consecutive treatments. MN frequency in lymphocytes and urinary excretion of 8OHdG, measured by high-performance liquid chromatography, were assessed before and 4 (MN only) and 20 h after radiation synovectomy. Results: Urinary excretion of 8OHdG in patients (in mu mol/mol creatinine; pretreatment mean, 3.1 +/- 3.4; median, 2.27) was not significantly different from that in healthy volunteers (mean, 2.0 +/- 1.2; median, 1.87) and not altered by radiation synovectomy (post-treatment mean, 2.5 +/- 1.5; median, 2.04, NS). An increase in 8OHdG levels after radiation synovectomy of more than 1 SD was found in only 1 patient, who experienced leakage to the lymph nodes but who already had elevated urinary 8OHdG levels before treatment. The frequency of MN/500 binucleated cells (BNCs) was slightly lower in patients (pretreatment mean, 4.3 +/- 2.6; median, 4.25) than in healthy volunteers (mean, 5.4 +/- 2.3; median, 5.3) and did not significantly change after therapy, either (4-h post-treatment mean, 3.9 +/- 2.1, median, 3.8; 20-h post-treatment mean, 4.1 +/- 2, median 3.8 MN/500 BNC). In 22 of 27 treatments, no leakage to nontarget organs could be monitored, whereas leakage to the local lymph nodes and the liver was detected after 5 treatments. Conclusion: Radiation synovectomy using Dy-165-DFH causes no significant radiation burden to most patients as indicated by the absence of adverse changes in levels of biomarkers of cytogenetic damage and a low incidence of leakage. These data suggest that the risk of malignancy may not be elevated.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Arthritis - radionuclide imaging Arthritis - radiotherapy
- DNA Damage -
- Deoxyguanosine - analogs and derivatives Deoxyguanosine - urine
- Dysprosium - therapeutic use
- Female -
- Ferric Compounds - therapeutic use
- Humans -
- Immunoglobulins - diagnostic use
- Knee Joint - radiation effects Knee Joint - radionuclide imaging
- Male -
- Radioisotopes - therapeutic use
- Synovitis - radionuclide imaging Synovitis - radiotherapy
- Technetium - diagnostic use
- Tumor Markers, Biological - urine
- Find related publications in this database (Keywords)
- radiation synovectomy
- cytogenetic damage
- cancer
- biomarker