RADIODRUG: USE IN SENTINEL LYMPH NODE REMOVAL SURGERY

Abstract

Radioguided surgery is a great contribution to patients’ lives. And, the detection of the Sentinel Lymph Node (SL) aims to predict the lymph node condition. Therefore, the objective of the article is to analyze and clarify the use of radiopharmaceuticals in SL removal surgery. To this end, a literature review was carried out, with a qualitative and descriptive approach in the LILACS, SCIELO and Pubmed databases of articles published from 2013 onwards. 15 articles were selected. Radiopharmaceuticals are used in SL removal surgeries, breast, lung, head and neck, oral and oropharyngeal, cervical and endometrial cancers and melanomas. Radioguided surgery provides real-time information about the location, extent of the disease, integrity of the resection and confirmation of the resected tumor, taking advantage of radiopharmaceuticals that are preferentially absorbed by the tumor tissue. The ideal radioactive source presents rapid elimination at the injection site, rapid uptake, high retention in the first draining lymph node and low uptake by the distal lymph nodes. Radiopharmaceuticals used include 99m Tc-Rituximab, fTCSC, 99m Tc-Tilmanocept, 99Tc-AuNP, 99m Tc-mannosyl and FITA-TEC, 18 F-FDG, 99mTc, indigo carmine and ICG. Therefore, a better understanding of the lymphatic system opens up a new era in the treatment of malignancies with lymphatic dissemination. And, the routine use of SLN biopsy allows cancer to be detected effectively and accurately, with the use of safe radiopharmaceuticals allowing better clinical outcomes, and with this, an improvement in the patient's quality of life is expected.