Treatment with 90Y- and 177Lu-DOTATOC in patients with metastatic neuroendocrine tumors
Treatment with 90Y- and 177Lu-DOTATOC in patients with metastatic neuroendocrine tumors
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DOI：
10.1016/j.surg.2006.07.030
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发表时间：
2006-12-01
期刊：
影响因子：
3.8
通讯作者：
Broelsch, Christoph E.
中科院分区：
文献类型：
--
作者：
Frilling, Andrea;Weber, Frank;Broelsch, Christoph E.
背景用Y-90或Lu-177-DOTATOC治疗最近已被引入到表达生长抑素受体的神经内分泌肿瘤（NET）的姑息治疗中。本研究的目的是通过介绍Y-90和Lu-177-DOTATOC治疗NET的临床经验。为了证明治疗的适用性，每例患者均接受了In-111-DTPAOC或Ga-68-DOTATOC正电子发射断层扫描/计算机断层扫描。所有患者均接受[Y-90-DOTATOC]作为初始治疗。在疾病复发的情况下，重复治疗。为避免重复应用[Y-90]的副作用，转换为[Lu-177-DOTATOC]。记录临床、生化和放射影像学反应。纳入了20例转移性不可切除的NET患者（15例胰腺NET，2例中肠A β，1例胃泌素瘤，1例副神经节瘤，1例原发灶不明的NET）。8例患者重复治疗一次以上（平均3次;范围2-5次）。[Y-90]治疗后，在8例患者中观察到中度毒性。无严重不良事件可记录。再分期后，5例患者部分缓解，11例患者病情稳定，4例患者肿瘤进展。Peplide受体靶向放射性核素治疗是一种有前途的，安全的，可行的方法在姑息治疗NET患者。
Background. Treatment with Y-90- or Lu-177-DOTATOC has recently been introduced in the palliative treatment Of somatostatin receptor-expressing neuroendocrine tumors (NETs). The aim of the study vias to present clinical experience with Y-90- and Lu-177-DOTATOC therapy in the management of NET.Methods. To prove suitability for treatment each patient underwent scanning with In-111-DTPAOC or Ga-68-DOTATOC positron emission tomography/computed tomography. All patients received [Y-90-DOTATOC] as initial treatment. In case of disease relapse the treatment was repeated. To avoid side effects of repeated [Y-90] applications, a switch to [Lu-177-DOTATOC] was carried out. Clinical, biochemical, and radioimaging responses were documented.Results. Twenty patients with metastatic nonresectable NETs (15 pancreas NETs, 2 midgut AETs, 1 gastrinoma, I paraganglioma, I NET of unknown primary origin) were included. In 8 patients the treatment was repeated more than once (mean, 3 times; range, 2-5 times). After [Y-90] treatment moderate toxicity was observed in 8 patients. No serious adverse events were documentable. After restaging, a partial remission was found in 5 patients, stable disease in 11 patients, and tumor progression in 4 patients.Conclusions. Peplide receptor-targeted radionuclide therapy is a promising, safe, and feasible approach in the palliative therapy of patients with NET.