2634 - A Model for a Community Radiation Oncology Cancer Center Providing a Comprehensive Spectrum of Radiopharmaceutical Treatment

Purpose/Objective(s): Radiopharmaceuticals have been growing in interest and utilization. Different centers have taken various routes to providing this important service to its patients. The purpose of this work is to review and report on the unique experience of a single institution with multiple radiation oncology clinics that have a 20-year history of providing the complete array of radiopharmaceutical treatments. Patients were seen for radioactive iodine (I-131), liver radioembolization (Y-90), neuroendocrine tumors (Lu177), metastatic prostate cancer (Lu177), bone metastases (Ra225), and lymphoma (monoclonal antibody treatment with I-131 or Y-90).

Materials/Methods: Depending on the radiopharmaceutical and the institution, patient evaluation and treatment might be conducted in many different departments (nuclear medicine, interventional radiology, and radiation oncology). In an effort to assure that every patient has true multidisciplinary care, all patients in this institution are seen in consultation and then treated by radiation oncology alone or in conjunction with other disciplines. The radiation oncology medical physicists historically handled the receipt, administration and residual storage of the radiopharmaceutical doses. More recently, the department has hired nuclear medicine trained technician to further support the program. Additional staff to support the program growth includes dedicated billing resources, scheduling resources, and nursing.

Results: From 2022 to 2024, 136 patients were treated with radiopharmaceuticals for neuroendocrine tumors, 196 patients were treated for extra osseus and osseus metastatic prostate cancer with Lu177, and 25 patients with bone predominant metastatic prostate cancer treated with Ra225. Over the same period, 180 administrations of radioactive iodine were performed, and 145 patients were treated in conjunction with interventional radiology with radioembolization utilizing Y-90 radiopharmaceuticals. In addition, patients were enrolled on multiple different clinical studies of radiopharmaceuticals. The administration of radiopharmaceuticals involves additional staff, safety procedures and effort, but has positively contributed financially.

Conclusion: Radiopharmaceutical have been utilized since the first treatment of thyroid cancer in 1942. Since then, various treatments have been performed leading to the wide variety of disease types treated today. We demonstrate how these treatments can be incorporated into the workflow of a standard community-based radiation oncology clinic and its satellites.