Name of the Procedure:

Yttrium Y-90 Ibritumomab Tiuxetan Therapy
Common Name: Zevalin Therapy
Technical/Medical Term: Radioimmunotherapy using Yttrium-90 labeled Ibritumomab Tiuxetan (code A9543)

Summary

Yttrium Y-90 Ibritumomab Tiuxetan therapy, also known as Zevalin Therapy, is a targeted treatment for certain types of cancer, primarily non-Hodgkin's lymphoma. The therapy combines an antibody with a radioactive substance to locate and destroy cancer cells without causing significant harm to surrounding healthy tissues.

Purpose

The primary purpose of this therapy is to treat non-Hodgkin's lymphoma, particularly in cases where other treatments have not been successful. The goal of the procedure is to deliver radiation directly to the cancer cells, reducing tumor size and progression, and potentially achieving remission.

Indications

• Non-Hodgkin’s lymphoma, specifically follicular lymphoma
• Relapsed or refractory lymphoma (cancers that have returned or are resistant to previous treatments)
• Patients who have undergone prior chemotherapy but need further treatment

Preparation

• Pre-procedure blood tests to ensure adequate blood counts
• Possible imaging scans (e.g., PET, CT) to assess the extent of the disease
• Review of the patient's medical history and current medications
• Patients may be advised to fast for a few hours before the procedure
• Avoidance of certain medications as instructed by the healthcare provider

Procedure Description

1. Initial Antibody Infusion: A non-radioactive dose of rituximab (an antibody) is initially administered to target cancer cells and help the radioactive therapy.
2. Radioactive Drug Administration: One week after the initial infusion, the patient receives an intravenous infusion of Yttrium-90 labeled Ibritumomab Tiuxetan.
3. Monitoring: Vital signs and blood counts are monitored during and after the infusion.

Tools/Equipment:

• Infusion pump
• Yttrium-90 labeled Ibritumomab Tiuxetan (Zevalin)
• Rituximab

Anesthesia/Sedation:

• Typically, no anesthesia is required.

Duration

The entire therapy involves two sessions approximately one week apart, with each session taking about 1-2 hours.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or a specialized cancer treatment center.

Personnel

• Oncologist or Hematologist
• Nuclear Medicine Specialist
• Registered Nurses
• Radiologist (for imaging studies)

Risks and Complications

• Common: Mild fatigue, nausea, temporary decrease in blood cell counts
• Rare: Severe infection, bleeding, allergic reactions, secondary cancers

Benefits

• Targeted destruction of cancer cells with minimal damage to surrounding tissues
• Reduction in tumor size
• Potential for achieving remission
• Benefit realization may occur within weeks to months following treatment

Recovery

• Regular follow-up appointments for blood tests and assessment
• Instructions on managing side effects, such as fatigue and low blood counts
• Avoiding strenuous activities and exposure to infections
• Expected recovery time varies; patients may experience fatigue for several weeks

Alternatives

• Chemotherapy: Systemic treatment but with potentially significant side effects
• External Beam Radiation: Localized radiation but without the targeting precision
• Stem Cell Transplant: More invasive with longer recovery and higher risks
• Immunotherapy: Uses the body’s immune system but may not be as targeted

Each alternative varies in effectiveness, side effects, and appropriateness depending on the individual patient’s condition.

Patient Experience

During the procedure, patients may feel minor discomfort from the IV infusion. Post-procedure, they may experience fatigue, mild nausea, or a decrease in blood counts. Pain management and comfort measures, such as rest and hydration, are recommended. Regular check-ups and monitoring ensure any complications are managed promptly.