van der Hiel Bernies, Stokkel Marcel P M, Chiti Arturo, Lucignani Giovanni, Bajetta Emillio, Pauwels Ernest K J, Bombardieri Emilio
Department of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Eur J Endocrinol. 2003 Dec;149(6):479-83. doi: 10.1530/eje.0.1490479.
To evaluate therapy with high doses of (111)Indium pentetreotide in a patient with bone metastases from a carcinoid of the pancreas.
A 55-Year-old male presented in November 1990 with stomach ache with dorsal irradiation. Ultrasonography and computed tomography (CT-) scans of the abdomen revealed a tumour of the tail of the pancreas and liver metastases. Histological examination revealed a neuroendocrine tumour. Surgery and polychemotherapy were initiated and after seven cycles a tumour regression of 30% was achieved. During follow-up multiple metastases were seen upon bone scintigraphy for which treatment with high doses Indium-111-octreotide was initiated.
The patient underwent eight cycles, with one cycle every 5 weeks. Each treatment consisted of an i.v. injection of 6 GBq Indium-111-pentetreotide. Comparing the results of the first and the last post-treatment scintigraphy, a regression of the number and intensity of uptake in the lesions was found. Bone scintigraphy showed a regression of the skeletal lesions as well, while X-ray, CT-scan and chromogranin-A levels showed stable disease.
Results from the treatment of our patient indicate that the use of high dose radiolabelled somatostatin analogues could be of significant use, even in the case of bone metastases. To our knowledge, this is the first report describing therapeutic effects on bone metastases from a neuroendocrine tumour.
评估高剂量的（111）铟喷替酸五肽治疗胰腺类癌骨转移患者的疗效。
一名55岁男性于1990年11月因伴有背部放射痛的胃痛就诊。腹部超声和计算机断层扫描（CT）显示胰腺尾部肿瘤及肝转移。组织学检查显示为神经内分泌肿瘤。开始进行手术及多药化疗，七个周期后肿瘤缩小30%。随访期间骨闪烁显像发现多处转移，遂开始用高剂量的铟-111-奥曲肽治疗。
患者接受了八个周期的治疗，每5周一个周期。每次治疗包括静脉注射6GBq铟-111-喷替酸五肽。比较首次和末次治疗后闪烁显像的结果，发现病变摄取的数量和强度有所降低。骨闪烁显像也显示骨骼病变有所减轻，而X线、CT扫描和嗜铬粒蛋白A水平显示病情稳定。
对该患者的治疗结果表明，即使在骨转移的情况下，使用高剂量放射性标记的生长抑素类似物也可能有显著作用。据我们所知，这是第一份描述对神经内分泌肿瘤骨转移有治疗效果的报告。
