Ki-67 增殖指数对肽受体放射性核素治疗反应的影响。
Impact of the Ki-67 proliferation index on response to peptide receptor radionuclide therapy.
机构信息
Department of Nuclear Medicine, University Hospital, Bonn, Germany.
出版信息
Eur J Nucl Med Mol Imaging. 2011 Mar;38(3):459-66. doi: 10.1007/s00259-010-1610-2. Epub 2010 Sep 18.
PURPOSE
The role of the Ki-67 tumour proliferation index (PI) in predicting the efficacy of peptide receptor radionuclide therapy (PRRT) in gastroenteropancreatic tumours (GEP-NET) remains undetermined. This single-centre analysis focused on the potential therapeutic impact of this immunohistochemical parameter.
METHODS
A total of 81 consecutive GEP-NET patients treated with (177)Lu-DOTA-octreotate (mean activity of 7.9 GBq per cycle, usually four treatment cycles at standard intervals of 3 months) were retrospectively analysed. Both an evaluable PI and tumour response (modified SWOG criteria) were required for patient inclusion.
RESULTS
Response of tumours with a PI of ≤20% (partial response 40%, minor response 15%, stable disease 34%, progressive disease 11%) was comparable in all PI subsets, including those with a PI of 20%. However, G3 tumours (PI > 20%) showed progression in 71% of patients.
CONCLUSION
Response to PRRT is consistent over the PI range of ≤20% (G1 + G2). Contrary to preliminary previous suggestions, a PI of 15% or 20% should not preclude candidates from somatostatin receptor-targeted radiotherapy.
目的
Ki-67 肿瘤增殖指数（PI）在预测胃肠胰神经内分泌肿瘤（GEP-NET）肽受体放射性核素治疗（PRRT）疗效中的作用仍不确定。本单中心分析侧重于该免疫组织化学参数的潜在治疗影响。
方法
回顾性分析了 81 例连续接受（177）Lu-DOTA-奥曲肽（每个周期的平均活性为 7.9GBq，通常每 3 个月标准间隔进行四个治疗周期）治疗的 GEP-NET 患者。患者纳入需要有可评估的 PI 和肿瘤反应（改良 SWOG 标准）。
结果
PI≤20%的肿瘤（部分缓解 40%，轻微缓解 15%，稳定疾病 34%，进展疾病 11%）的反应在所有 PI 亚组中相似，包括 PI 为 20%的亚组。然而，PI＞20%的 G3 肿瘤患者中有 71%出现进展。
结论
PRRT 的反应在 PI 范围≤20%（G1+G2）内是一致的。与初步的先前建议相反，15%或 20%的 PI 不应排除生长抑素受体靶向放疗的候选者。
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