Factors Associated with Radiation Safety Clearance Following Lu-177 DOTATATE Therapy

Abstract

Abstract Objective To identify factors associated with early achievement of radiation safety discharge criteria following Lu-177 DOTATATE therapy and to evaluate longitudinal changes in renal function and hematological parameters in clinical practice. Methods This retrospective single-center study included patients with neuroendocrine tumors who received Lu-177 DOTATATE therapy between December 2021 and March 2025. The primary outcome was achievement of discharge criteria within 4 hours after administration. Factors associated with early achievement were analyzed using generalized estimating equations to account for repeated treatment cycles. Exploratory analyses were performed to evaluate the association between oral hydration volume and time to discharge among patients who achieved discharge criteria. Results Sixty patients underwent a total of 134 Lu-177 DOTATATE administrations. Higher pre-treatment creatinine clearance was independently associated with achievement of discharge criteria within 4 hours (odds ratio 1.22 per 10 mL/min increase, 95% confidence interval 1.01–1.49, p = 0.044). Oral hydration volume was not independently associated with the outcome in multivariable analysis. However, patients with both impaired renal function (creatinine clearance