Patients receiving lutetium Lu 177 dotatate radiation therapy may experience travel delays

Aug. 14, 2020

Lutetium Lu 177 dotatate, a peptide receptor radionuclide therapy (PRRT), is a tumor-targeted treatment that uses radiation to induce tumor cell death in neuroendocrine tumors (NETs) via a β particle-emitting radionuclide linked to a somatostatin peptide analog.

Patients undergoing this treatment for advanced somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors have experienced significant delays at U.S. ports of entry for additional security screenings while traveling.

The radiation used in the treatment persists for several weeks at a low level and can be detected by sensitive radiation detectors at U.S. ports of entry, including international airports and border crossings by boat, car or foot, according to a recently published article in The Journal of Nuclear Medicine (JNM).

"Disruption in travel, especially if not anticipated, can be extremely distressing for patients who have enough to deal with already. For many such patients, this travel is meant to take the mind off of their disease. Being stopped at borders is, without a doubt, potentially traumatic," said Thorvardur (Thor) R. Halfdanarson, M.D., medical oncologist and professor of oncology at Mayo Clinic in Rochester, Minnesota.

Patients typically receive this therapy in four cycles with two months between treatments. Between these treatments, and up to three months after therapy completion, going through U.S. ports of entry and other high-security areas can result in security-related delays.

To help avoid travel delays, patients should be counseled about the possibility of radiation detection when traveling during and after each cycle of PRRT. It's recommended that clinical care teams give patients a travel card to help avoid delays.

The travel card should contain:

  • The patient's personal identification
  • The type of radiation received
  • The dose of radiation administered
  • The date radiation was administered
  • The name of the treating institution
  • The institution's contact information with 24/7 access if further information is required

Providers should counsel patients to:

  • Allow for extra time when traveling, particularly when transferring between international and domestic flights
  • Remain calm if they are approached by a security officer
  • Be prepared to present their travel card
  • Carry a copy of their most-recent clinic notes in a single envelope

A public online survey performed by one of the authors of the JNM article showed that most patients are treated with respect at the U.S. ports of entry and high-security areas. However, screening procedures took approximately one to two hours, and in some cases even longer. Some patients also reported they had to go through radiation detectors multiple times.

For more information

Kendi AT, et al. Patient travel concerns after treatment with 177 Lu-dotatate. The Journal of Nuclear Medicine. 2020;61:496.