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多肽受体放射性核素治疗(PRRT)的重复周期——放射性同位素 90Y-DOTA TATE、177Lu-DOTA TATE 或 90Y/177Lu-DOTA TATE 治疗弥散性神经内分泌肿瘤患者的结果和副作用。

Repeated cycles of peptide receptor radionuclide therapy (PRRT)--results and side-effects of the radioisotope 90Y-DOTA TATE, 177Lu-DOTA TATE or 90Y/177Lu-DOTA TATE therapy in patients with disseminated NET.

机构信息

Nuclear Medicine Unit, Endocrinology Department, Jagiellonian University, Krakow, Poland.

出版信息

Radiother Oncol. 2012 Jan;102(1):45-50. doi: 10.1016/j.radonc.2011.08.006. Epub 2011 Aug 30.

Abstract

PURPOSE

PRRT is a known tool in the management of patients with disseminated and inoperable NETs. The aim of study was to assess the effectiveness of the repeated cycles of PRRT in patients with disseminated and inoperable NETs.

MATERIAL AND METHODS

Eighty nine patients were included in the PRRT. Among them 16 patients (18%) were qualified for a repeated PRRT cycle due to progression of the disease. In one of the patients qualified for the repeated cycle, PRRT was used as neoadjuvant therapy. The results and side-effects of the repeated cycles of PRRT were analyzed.

RESULTS

Disease stabilization was observed in 10 patients 6 months after the repeated PRRT cycle and in 5 patients after 12 and 18 months. Ten of the patients who had received repeated PRRT cycles died. In the case of neoadjuvant therapy, further reduction of the tumor size was observed, enabling qualification for surgery. Clinically significant reduction in the mean values of morphological parameters was not observed. Only after 12 and 18 months the mean values of creatinine levels were higher than the normal range (only in 2 patients).

CONCLUSIONS

The repeated cycles of PRRT did not cause a clinically significant increase of the toxicity of PRRT. The changes in kidney and blood morphology parameters were transient. The repeated cycles of PRRT enabled stabilization of the disease.

摘要

目的

肽受体放射性核素治疗(PRRT)是治疗广泛转移和不可切除神经内分泌肿瘤(NETs)的有效手段。本研究旨在评估重复 PRRT 周期在广泛转移和不可切除 NETs 患者中的疗效。

材料和方法

共纳入 89 例接受 PRRT 的患者。其中 16 例(18%)因疾病进展符合重复 PRRT 周期的条件。在符合重复周期条件的患者中,有 1 例患者将 PRRT 作为新辅助治疗。分析了重复 PRRT 周期的结果和副作用。

结果

重复 PRRT 周期后 6 个月,10 例患者疾病稳定,12 个月和 18 个月后 5 例患者疾病稳定。10 例接受重复 PRRT 周期的患者死亡。在新辅助治疗的情况下,观察到肿瘤体积进一步缩小,从而符合手术条件。未观察到形态学参数的平均数值有临床意义的降低。仅在 12 个月和 18 个月时,肌酐水平的平均值高于正常值(仅在 2 例患者中)。

结论

重复 PRRT 周期并未导致 PRRT 毒性的临床显著增加。肾脏和血液形态参数的变化是短暂的。重复 PRRT 周期能够稳定疾病。

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