Glioblastoma（GB）是最恶性的原发性脑肿瘤，因此引入新的治疗选项至关重要。本研究旨在评估 α放射性体[213Bi]Bi-DOTA-substance P（SP）和[225Ac]Ac-DOTA-SP 的局部治疗。在复发性原发和继发GB患者中进行治疗作为救治方案。20名原发性（48.2 ± 11.8岁）和9名继发性（38.8 ± 10.8岁）GB患者使用注射活性为1.85 GBq的[213Bi]Bi-DOTA-SP进行治疗，而15名原发性（45.1 ± 9.9岁）和6名继发性（37.8 ± 6.4岁）GB患者使用剂量递增技术（10,20和30 MBq）的[225Ac]Ac-DOTA-SP进行治疗。用[213Bi]Bi-DOTA-SP和[225Ac]Ac-DOTA-SP进行局部治疗是良好耐受的，只有少量不良反应。在生存参数上，[213Bi]Bi-DOTA-SP和[225Ac]Ac-DOTA-SP组之间没有显著差异。对于原发性GB，使用[213Bi]Bi-DOTA-SP和[225Ac]Ac-DOTA-SP进行治疗的患者的生存参数如下（以月为单位）：无进展生存时间为2.7与2.4，总体生存的时间（从诊断到死亡的总体生存时间），分别为23.6与21.0；从治疗开始到死亡的总体生存时间分别为7.5与5.0，从原发肿瘤复发到死亡的总体生存时间分别为10.9与12.0。治疗[213Bi]Bi-DOTA-SP和[225Ac]Ac-DOTA-SP的继发性GB患者的生存参数如下（以月为单位）：无进展生存时间为5.8与2.4，总体生存的时间分别为52.3与65.0，从治疗开始到死亡的总体生存时间分别为16.4与16.0，从转化为继发GB多形性到死亡的总体生存时间分别为18.4与36.0。213Bi或225Ac的相似性结果表明，脑肿瘤的局部治疗可以大大简化。迄今为止的经验表明，脑肿瘤的局部放射性同位素治疗需要进一步进行剂量测量研究，考虑到生物学过程的复杂性。版权所有©2023 Wolters Kluwer Health，Inc。保留所有权利。

Glioblastoma (GB) is the most malignant primary brain tumor. Therefore, introduction of new treatment options is critically important. The aim of this study was to assess local treatment with α emitters [213Bi]Bi-DOTA-substance P (SP) and [225Ac]Ac-DOTA-SP.Treatment was performed as salvage therapy in patients with recurrent primary and secondary GB. [213Bi]Bi-DOTA-SP with injected activity 1.85 GBq per cycle was used in 20 primary (48.2 ± 11.8 years old) and in 9 secondary (38.8 ± 10.8 years old) GB patients and [225Ac]Ac-DOTA-SP in 15 primary (45.1 ± 9.9 years old) and in 6 secondary (37.8 ± 6.4 years old) GB patients with a dose escalation scheme (10, 20, and 30 MBq).Local treatment with [213Bi]Bi-DOTA-SP and [225Ac]Ac-DOTA-SP was well tolerated with only few adverse effects. There was no statistically significant difference between [213Bi]Bi-DOTA-SP and [225Ac]Ac-DOTA-SP groups in survival parameters. For primary GB, survival parameters of patients treated with [213Bi]Bi-DOTA-SP and [225Ac]Ac-DOTA-SP were as follows(in months): progression-free survival time, 2.7 versus 2.4; OS-d (overall survival from time of diagnosis to death from any cause), 23.6 versus 21.0; OS-t (overall survival from the start of treatment to death from any cause), 7.5 versus 5.0; and OS-r (overall survival from recurrence in primary tumors to death from any cause), 10.9 versus 12.0. Survival parameters of secondary GB patients treated with [213Bi]Bi-DOTA-SP and [225Ac]Ac-DOTA-SP were as follows (in months): progression-free survival time, 5.8 versus 2.4; OS-d, 52.3 versus 65.0; OS-t, 16.4 versus 16.0; and OS-c (overall survival from conversion into secondary GB multiforme to death from any cause), 18.4 versus 36.0.The similarity results of 213Bi or 225Ac may suggest that the local treatment of brain tumors can be greatly simplified. The experience to date shows that local radioisotope treatment of brain tumors requires further dosimetry studies, taking into account the complexity of biological processes.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.