Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Semin Nucl Med. 2010 Mar;40(2):78-88. doi: 10.1053/j.semnuclmed.2009.10.004.
Somatostatin receptor imaging with [(111)In-DTPA(0))octreotide has proven its role in the diagnosis and staging of gastroenteropancreatic neuroendocrine tumors. Treatment with radiolabeled somatostatin analogues is a promising new tool in the management of patients with inoperable or metastasized, well-differentiated neuroendocrine tumors. Symptomatic improvement may occur with all (111)In, (90)Y, or (177)Lu-labeled somatostatin analogues that have been used for peptide receptor radionuclide therapy. The results that were obtained with [(90)Y-DOTA(0), Tyr(3)]octreotide and [(177)Lu-DOTA(0), Tyr(3)]octreotate are very encouraging in terms of tumor regression. Also, if kidney protective agents are used, the side effects of this therapy are few and mild, and the median duration of the therapy response for these radiopharmaceuticals is 30 and 40 months, respectively. The patients' self-assessed quality of life increases significantly after treatment with [(177)Lu-DOTA(0), Tyr(3)]octreotate. Finally, compared with historical controls, there is a benefit in overall survival of several years from time of diagnosis in patients treated with [(177)Lu-DOTA(0), Tyr(3)]octreotate. These data compare favorably with the limited number of alternative treatment approaches. If more widespread use of peptide receptor radionuclide therapy can be guaranteed, such therapy may well become the therapy of first choice in patients with metastasized or inoperable gastroenteropancreatic neuroendocrine tumors.
奥曲肽 [(111)In-DTPA(0))] 生长抑素受体成像已被证明可用于胃肠胰神经内分泌肿瘤的诊断和分期。放射性标记生长抑素类似物治疗不可切除或转移性、分化良好的神经内分泌肿瘤是一种很有前途的新方法。用所有已用于肽受体放射性核素治疗的 [(111)In、(90)Y 或 (177)Lu]- 标记生长抑素类似物进行治疗时，可能会出现症状改善。用 [(90)Y-DOTA(0), Tyr(3)]奥曲肽和 [(177)Lu-DOTA(0), Tyr(3)]奥曲肽进行治疗的结果在肿瘤消退方面非常令人鼓舞。此外，如果使用肾脏保护剂，这种治疗的副作用很少且轻微，这些放射性药物的治疗反应中位持续时间分别为 30 个月和 40 个月。用 [(177)Lu-DOTA(0), Tyr(3)]奥曲肽治疗后，患者的自我评估生活质量显著提高。最后，与历史对照相比，用 [(177)Lu-DOTA(0), Tyr(3)]奥曲肽治疗的患者从诊断时间起总生存时间有几年的获益。这些数据与有限数量的替代治疗方法相比具有优势。如果能保证更广泛地使用肽受体放射性核素治疗，这种治疗方法很可能成为转移性或不可切除的胃肠胰神经内分泌肿瘤患者的首选治疗方法。
