Endocrinology Department, Jagiellonian University Medical College, Krakow, Poland.
Endokrynol Pol. 2011;62(5):392-400.
The aim of this study was to assess the efficacy and toxicity of peptide receptor radionuclide therapy (PRRT) with the use of the high affinity somatostatin receptor subtype 2 analogue, (90)Y labelled Tyr3-octreotate, ((90)Y-DOTATATE) in neuroendocrine tumours (NETs).
46 patients with disseminated or non-operable NET were enrolled in this study. The (90)Y-DOTATATE therapeutic activity was calculated per total body surface area up to a total of 7.4 GBq/m(2) administered in three to five cycles, repeated every four to nine weeks. Before and after the therapy, blood tests for haematology, kidney and liver function, and chromogranin A were performed.
Out of 46 (90)Y-DOTATATE treated patients, one died before completing the therapy and 16 died after completing the therapy, among them one due to myocardial infarction. After 12 month follow-up, stabilisation of disease was observed in 47%, partial remission in 31%, and progression in 9% of the 45 patients who completed the therapy. Five patients died before completion of 12 months of follow-up. One of the patients died due to myocardial infarction. In one case, the information after 12 months is incomplete. The progression free survival was 37.4 months. During 12 months follow-up, transient decrease of PLT, WBC and haemoglobin values was observed. A transient increase of creatinine level (within normal ranges) and decrease of GFR values were found.
NETs (90)Y-DOTATATE therapy results in symptomatic relief and tumour mass reduction. The mild critical organ toxicity does not limit the PRRT of NETs.
本研究旨在评估使用高亲和力生长抑素受体亚型 2 类似物（90）Y 标记的 Tyr3-奥曲肽（（90）Y-DOTATATE）进行肽受体放射性核素治疗（PRRT）治疗神经内分泌肿瘤（NET）的疗效和毒性。
本研究纳入了 46 例播散性或不可手术的 NET 患者。根据总表面积计算（90）Y-DOTATATE 的治疗活性，最高可达 7.4GBq/m2，分 3-5 个周期给予，每个周期间隔 4-9 周。治疗前后，进行血液学、肾功能和肝功能以及嗜铬粒蛋白 A 检测。
在接受（90）Y-DOTATATE 治疗的 46 例患者中，1 例在完成治疗前死亡，16 例在完成治疗后死亡，其中 1 例死于心肌梗死。在 12 个月的随访中，完成治疗的 45 例患者中，疾病稳定者占 47%，部分缓解者占 31%，进展者占 9%。在完成 12 个月随访之前，有 5 例患者死亡。其中 1 例死于心肌梗死。在 1 例患者中，12 个月后的信息不完整。无进展生存时间为 37.4 个月。在 12 个月的随访期间，观察到血小板（PLT）、白细胞（WBC）和血红蛋白值短暂下降。发现肌酐水平（在正常范围内）一过性升高和肾小球滤过率（GFR）值下降。
NETs（90）Y-DOTATATE 治疗可缓解症状和缩小肿瘤体积。轻微的重要器官毒性不会限制 NETs 的 PRRT。
