Prospective observational study of (177)Lu-DOTA-octreotate therapy in 200 patients with advanced metastasized neuroendocrine tumours (NETs): feasibility and impact of a dosimetry-guided study protocol on outcome and toxicity.
Prospective observational study of (177)Lu-DOTA-octreotate therapy in 200 patients with advanced metastasized neuroendocrine tumours (NETs): feasibility and impact of a dosimetry-guided study protocol on outcome and toxicity.
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DOI：
10.1007/s00259-018-3945-z
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发表时间：
2018-06
影响因子：
9.1
通讯作者：
Granberg D
中科院分区：
文献类型：
--
作者：
Garske-Román U;Sandström M;Fröss Baron K;Lundin L;Hellman P;Welin S;Johansson S;Khan T;Lundqvist H;Eriksson B;Sundin A;Granberg D
神经内分泌肿瘤患者的肽受体放射性疗法已产生了前瞻性研究。
该研究组完成了200例转移的生物抑制素受体阳性神经内分泌肿瘤，这些患者在标准治疗上进行，或者不适合其他治疗周期。并重复循环，直到肾脏吸收的剂量达到23 Gy，或者还有其他原因阻止了KI-67 47例患者（23.5％）的指数≤2％，121例（60.5％）的指数为3-20％，16例（8％）中的指数≤2％。
在123例（61.5％）中，对肾脏的吸收剂量在一线治疗期间以3至9个周期达到23 Gy。 ）是1名患者（0.5％）的完全反应（CR），47（23.5％）的部分反应（PR），135（67.5％）的稳定疾病（SD）和7（3.5（3.5）的进展疾病（PD）中的稳定疾病（SD） ％）所有患者的无进展生存期为27个月（95％CI 22-30个月），其中33个月的吸收剂量达到了23 Gy和15个月的中位数中位数。 OS）在所有患者中为43个月（95％CI 39-53个月），在54个月中，吸收的儿童剂量达到了23 Gy和25个月的中位数患有PR或CR最佳反应的患者60个月，患有SD的患者为42个月，患有PD患者16个月（1.5％）患有急性白血病。患者（15％）3级或4级骨髓毒性（4％）患有2级肾脏毒性和一名患者（0.5％）4级肾脏毒性。
用177lu-dota-凝结剂的剂量剂量可行的剂量。 。骨髓剂量测定没有预测毒性。
Peptide receptor radionuclide therapy in patients with neuroendocrine tumours has yielded promising results. This prospective study investigated the feasibility of dosimetry of the kidneys and bone marrow during therapy and its impact on efficacy and outcome. The study group comprised 200 consecutive patients with metastasized somatostatin receptor-positive neuroendocrine tumours progressing on standard therapy or not suitable for other therapeutic options. A treatment cycle consisted of 7.4 GBq 177Lu-DOTA-octreotate with co-infusion of a mixed amino acid solution, and cycles were repeated until the absorbed dose to the kidneys reached 23 Gy or there were other reasons for stopping therapy. The Ki-67 index was ≤2% in 47 patients (23.5%), 3–20% in 121 (60.5%) and >20% in 16 (8%). In 123 patients (61.5%) the absorbed dose to the kidneys reached 23 Gy with three to nine cycles during first-line therapy; in no patient was a dose to the bone marrow of 2 Gy reached. The best responses (according to RECIST 1.1) were a complete response (CR) in 1 patient (0.5%), a partial response (PR) in 47 (23.5%), stable disease (SD) in 135 (67.5%) and progressive disease (PD) in 7 (3.5%). Median progression-free survival was 27 months (95% CI 22–30 months) in all patients, 33 months in those in whom the absorbed dose to the kidneys reached 23 Gy and 15 months in those in whom it did not. Median overall survival (OS) was 43 months (95% CI 39–53 months) in all patients, 54 months in those in whom the absorbed dose to the kidneys reached 23 Gy and 25 months in those in whom it did not. Median OS was 60 months in patients with a best response of PR or CR, 42 months in those with SD and 16 months in those with PD. Three patients (1.5%) developed acute leukaemia, 1 patient (0.5%) chronic leukaemia (unconfirmed) and 30 patients (15%) grade 3 or 4 bone marrow toxicity. Eight patients (4%) developed grade 2 kidney toxicity and one patient (0.5%) grade 4 kidney toxicity. Dosimetry-based therapy with 177Lu-DOTA-octreotate is feasible. Patients in whom the absorbed dose to the kidneys reached 23 Gy had a longer OS than those in whom it did not. Patients with CR/PR had a longer OS than those with SD. Bone marrow dosimetry did not predict toxicity.
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影响因子：
3.2
作者：
Larsson M;Bernhardt P;Svensson JB;Wängberg B;Ahlman H;Forssell-Aronsson E
通讯作者：
Forssell-Aronsson E
影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
45.3
作者：
Imhof, Anna;Brunner, Philippe;Walter, Martin A.
通讯作者：
Walter, Martin A.
DOI：
10.1007/s00259-015-3190-7
发表时间：
2016-03-01
影响因子：
9.1
作者：
Mariniello, Annapaola;Bodei, Lisa;Grana, Chiara Maria
通讯作者：
Grana, Chiara Maria
影响因子：
50.5
作者：
Krenning, EP;de Jong, M;Valkema, R
通讯作者：
Valkema, R