Molecular radiotherapy (MRT) may also sometimes be referred to as radionuclide or radioisotope therapy. MRT is a form of radiotherapy which utilises a radioactive medication. This can be administered orally (through the mouth) or intravenously (through the veins), directly targeting tumour tissue, wherever it is in the body. The Molecular Radiotherapy Service at University College London provides treatment for adults, children, teenagers and young adults.
The molecular radiotherapy service includes a multi-disciplinary team including radiographers, clinical scientists, play specialists, physicists, oncologists, endocrinologists, surgeons, nuclear medicine physicians and radiologists.
The administration may be done as an outpatient appointment or it may be necessary for you to be admitted in a specialised treatment suite. The length of stay will be determined by the treatment you receive. The molecular radiotherapy team will ask a series of questions to predict when you may be discharged. Your radioactivity levels will also be monitored throughout your stay. The number of treatments can vary from a single administration to multiple administrations and is tailored according to your individual needs.
Prior to receiving molecular radiotherapy your suitability and eligibility for this treatment will need to be assessed, a consultant oncologist will go through this in more detail with you.
Following your administration of a radioactive drug, you may also require a nuclear medicine scan to show where the radioactive drug has been absorbed within your body.
Radioiodine therapy is an effective treatment for overactive and / or enlarged thyroid glands. It has been used all over the world for more than 70 years. Approximately 10,000 people of all ages are treated with radioiodine each year in the UK.
The thyroid is a gland in the neck that makes hormones that control your blood pressure and body temperature. To perform its normal function, the thyroid needs iodine, which is absorbed from the food we eat. Radioiodine is a special type of iodine that is radioactive. Radioiodine is taken up by the thyroid in the same way as normal iodine. The radiation that it gives out destroys cells in the thyroid, reducing its ability to make thyroid hormones.
Radioactive iodine (I-131) is a form of radiotherapy treatment called molecular radiotherapy (MRT) that has been used to treat thyroid cancer for many years. It is a targeted-method of destroying any remaining normal thyroid tissue or thyroid cancer cells that may remain following your total thyroidectomy surgery.
Your thyroid gland and related cells need iodine in order to work. They take up any iodine in the body. Radioactive iodine (I-131) is a type of iodine that is radioactive. You usually have radioactive iodine as a capsule or a drink. The radioactive iodine from the drink or capsule is absorbed into your body and picked up by the thyroid cancer cells, even if they have spread to other parts of the body. The radiation then destroys the cancer cells. It is known as targeted radiotherapy because the treatment goes straight to the cancer cells and has very little effect on healthy cells in the body.
Lutetium-177 PSMA Therapy, or Prostate-Specific Membrane Antigen Therapy, is an innovative therapeutic procedure that is increasingly being used for people with advanced prostate cancer. This is a type of “Peptide Receptor Radionuclide Therapy”.
Lutetium-177 PSMA treats prostate cancer cells around the body, can reduce the size of tumours and improve the symptoms caused by the prostate cancer. It is most often used when the prostate cancer has metastasised (spread to other parts of the body) and when other therapies are either poorly tolerated due to side effects or are no longer effective at controlling the prostate cancer.
Lutetium-177 PSMA therapy aims to control metastatic castration-resistant prostate cancer. The treatment is delivered into the vein via a drip and may be repeated for up to six treatments, booked 6 weeks apart.
Lutetium (Lu-177) dotatate treatment is a radioactive treatment that targets specific tumours called neuroendocrine tumours. These tumours are a group of rare cancers that develop in the neuroendocrine system, a system made up of nerve and gland cells that produce hormones. Dotatate is a chemical that is taken up by certain neuroendocrine tumours. Dotatate is attached to Lu-177, which is radioactive. The dotatate carries the radioactive Lu-177 in the bloodstream to the neuroendocrine tumour where it is absorbed. The Lu-177 delivers radiation to the cancer cells and kills them.
Combining radioactivity with drugs that target specific tumour cells is called molecular radiotherapy. You may also hear this being referred to as peptide receptor radionuclide therapy (PRRT). We aim to give patients a course of Lu-177 dotatate treatment every eight to twelve weeks, for a maximum of four courses. However this will depend on patients’ blood count recovery.
mIBG, pronounced meta-iodobenzyl guanidine, is the name of a drug, which targets specific tumours called neuroendocrine tumours. These tumours are group of rare cancers that develop in the neuroendocrine system (a system made up of nerve and gland cells that produce hormones). Neuroendocrine tumours include phaeochromocytoma, paraganglioma, metastatic neuroblastoma, medullary thyroid, and carcinoid tumours.
mIBG is attached to iodine-131 (I-131), a form of iodine which is radioactive. The mIBG carries the radioactive iodine-131 in the bloodstream to the cancer cells where it is absorbed. The iodine-131 delivers radiation to the cancer cells and kills them. Combining radioactivity with drugs that target specific tumour cells is called molecular radiotherapy.
Radium-223 is a radioactive substance used to treat prostate cancer that has spread to the bones (bone metastases). It is transported via the bloodstream to the bones. It then binds to the bones and delivers radiation.
Radium-223 emits alpha particles. The alpha particle is a high-energy radiation beam that travels only short distances. This allows it to target the cancer cells while causing minimal damage to the surrounding healthy cells.
Radium-223 can control painful bone metastases. It has also been shown to delay other potential complications of bone metastases, such as fractures, and to improve survival.
Selective Internal Radiotherapy (SIRT) is a form of radiotherapy which treats tumours in the liver. In SIRT this is a way of treating liver tumours whether they arise from the liver or have spread to the liver from elsewhere in the body such as the colon. Microscopic beads (microspheres) are injected into the artery, which carries the blood to the tumour. The beads become stuck in the small blood vessels around the tumour. These beads contain a radioactive isotope, which emits radiation that travels a very short distance in the liver. This means the radiation can damage the tumour cells, which are bear the beads. The radiation lasts for a period of a few days, but the treatment effect on the tumour can last much longer.
The Institute of Nuclear Medicine regularly supports clinical trials; this allows new treatments to be safely tested before being available for widespread use.
Your doctor may inform you that you or your child may be eligible to partake in a trial and will provide you with further information in both written and verbal form. Taking part in a trial is a choice and your wishes will be respected at all times.
To find out what trials the Institute are currently involved with please visit Find A Study – this will provide you with information on all trials open to recruitment at UCLH. You can filter the trials by health condition, treatment name or disease area to find out more.
For further information on clinical trials you can visit the National Institute of Health Research’s website Be Part of Research, which covers a wide range of trials across the UK.