van der Zwan Wouter A, Bodei Lisa, Mueller-Brand Jan, de Herder Wouter W, Kvols Larry K, Kwekkeboom Dik J
Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Eur J Endocrinol. 2015 Jan;172(1):R1-8. doi: 10.1530/EJE-14-0488. Epub 2014 Aug 12.
Peptide receptor radionuclide therapy (PRRT) is a promising new treatment modality for inoperable or metastasized gastroenteropancreatic neuroendocrine tumors (GEPNETs) patients. Most studies report objective response rates in 15-35% of patients. Also, outcome in terms of progression free survival (PFS) and overall survival compares very favorably with that for somatostatin analogs, chemotherapy, or new, 'targeted' therapies. They also compare favorably to PFS data for liver-directed therapies. Two decades after the introduction of PRRT, there is a growing need for randomized controlled trials comparing PRRT to 'standard' treatment, that is treatment with agents that have proven benefit when tested in randomized trials. Combining PRRT with liver-directed therapies or with targeted therapies could improve treatment results. The question to be answered, however, is whether a combination of therapies performed within a limited time-span from one another results in a better PFS than a strategy in which other therapies are reserved until after (renewed) tumor progression. Randomized clinical trials comparing PRRT with other treatment modalities should be undertaken to determine the best treatment options and treatment sequelae for patients with GEPNETs.
肽受体放射性核素治疗（PRRT）是一种对无法手术或已转移的胃肠胰神经内分泌肿瘤（GEPNETs）患者很有前景的新治疗方式。大多数研究报告称，15%至35%的患者有客观缓解率。此外，就无进展生存期（PFS）和总生存期而言，其结果与生长抑素类似物、化疗或新的“靶向”疗法相比非常有利。它们与肝导向疗法的PFS数据相比也很有利。在引入PRRT二十年后，越来越需要进行随机对照试验，将PRRT与“标准”治疗进行比较，即与在随机试验中已证明有益的药物治疗进行比较。将PRRT与肝导向疗法或靶向疗法联合使用可能会改善治疗效果。然而，需要回答的问题是，在彼此有限的时间范围内进行的联合治疗是否比将其他疗法留到（再次）肿瘤进展后再进行的策略能带来更好的PFS。应开展将PRRT与其他治疗方式进行比较的随机临床试验，以确定GEPNETs患者的最佳治疗选择和治疗后遗症。
