Y-90 Dotatoc Therapy Administration

-  Refer to  Dose Estimation  for the activity to give. Keep bone marrow radiation dose below 2 Gy.

-  Install iv line 1: In 4 h pass 8,5% aminoacid solution 1500 ml, plus 30 ml 10%. magnesium sulfate, plus 500 ml lactate ringer, starting 30 min before dotatoc 90Y. At the beggining ondansetron 8mg iv and dexamethasone 4 mg iv as well must be given to diminish nausea and vomiting.

-  Install Iv line 2: Saline solution. Thirty min after starting solution 1, administer dotatoc diluted in 250 ml saline for 30 min to 60 min, afterwards, keep solution 1 running till finishing.

-  Detail in written form radiation protection directions to patient.

-  Somatostatin may be resumed 3 days after radiotherapy to ease carcinoid syndrome symptoms.

References:

1) Lisa Bodei, Marta Cremonesi, Chiara Grana, Paola Rocca, Mirco Bartolomei, Marco Chinol, Giovanni Paganelli. Receptor radionuclide therapy with 90Y-[DOTA]0-Tyr3-octreotide (90Y-DOTATOC) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging (2004) 31:1038–1046.