本文讨论了意大利镥 177 放射性药物疗法的发展状况，重点关注关于基于 [177Lu]Lu-DOTATATE 神经内分泌肿瘤和 [177Lu]Lu-PSMA-617 的批准治疗的患者管理实践定义的重要性用于转移性去势抵抗性前列腺癌。随着对此类疗法的需求增加，同时从限制性的住院要求过渡到更灵活的门诊选择，意大利的医疗机构面临着新的挑战。因此，这里描述了四种管理策略，从给药后立即出院到24小时住院治疗，并通过简单的模型评估其环境和辐射安全影响，旨在评估对当地人口和废水净化厂工人的有效剂量。结果表明，虽然较高的有效剂量可能是由立即出院的方式引起的，但它们仍然在可接受的限度内，特别是在处理较少数量的患者时。延长住院时间可以保证较高的辐射安全水平，但随着未来患者数量的预期增加，这种情况可能无法持续。版权所有 © 2024 健康物理学会。

This article addresses the evolving state of lutetium-177 radiopharmaceutical therapies in Italy, focusing on the importance of the definition of patient management practices regarding the approved treatments based on [177Lu]Lu-DOTATATE for neuroendocrine tumors and [177Lu]Lu-PSMA-617 for metastatic castration-resistant prostate cancer. Italian medical facilities are facing new challenges with the increase in the demand for such therapies while transitioning from restrictive hospitalization requirements to more flexible outpatient options. Therefore, four management strategies are described here, varying from immediate discharge after the administration to 24-h hospitalization, and their environmental and radiation safety implications are evaluated through simple models aimed at assessing the effective doses on the local population and wastewater purification plant workers. Results show that, while higher effective doses may be caused by an immediate discharge-based modality, they remain within acceptable limits, particularly when dealing with a smaller number of patients. Prolonged hospitalizations guarantee superior radiation safety levels but might not be sustainable with the expected increase in patient volumes in the future.Copyright © 2024 Health Physics Society.