Marincek Nicolas, Radojewski Piotr, Dumont Rebecca A, Brunner Philippe, Müller-Brand Jan, Maecke Helmut R, Briel Matthias, Walter Martin A
Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Institute of Nuclear Medicine, University Hospital Bern, Bern, Switzerland.
J Nucl Med. 2015 Feb;56(2):171-6. doi: 10.2967/jnumed.114.147256. Epub 2015 Jan 15.
Meningiomas express members of the somatostatin receptor family. The present study assessed the long-term benefits and harm of somatostatin-based radiopeptide therapy in meningioma patients.
Patients with progressive unresectable meningioma were treated with (90)Y-DOTATOC and (177)Lu-DOTATOC until tumor progression or permanent toxicity occurred. Multivariable Cox regression analyses were used to study predictors of survival.
Overall, 74 treatment cycles were performed on 34 patients. Stable disease was achieved in 23 patients. Severe hematotoxicity occurred in 3 patients, and severe renal toxicity in 1 patient. Mean survival was 8.6 y from the time of recruitment. Stable disease after treatment (hazard ratio, 0.017 vs. progressive disease; 95% confidence interval, 0.001-0.35; n = 34; P = 0.01) and high tumor uptake (hazard ratio, 0.046 vs. intermediate or low tumor uptake; 95% confidence interval, 0.004-0.63; n = 34; P = 0.019) were associated with longer survival.
(90)Y-DOTATOC and (177)Lu-DOTATOC are promising tools for treating progressive unresectable meningioma, especially in cases of high tracer uptake in the tumor.
脑膜瘤表达生长抑素受体家族成员。本研究评估了基于生长抑素的放射性肽疗法对脑膜瘤患者的长期益处和危害。
对进行性不可切除的脑膜瘤患者使用（90）Y - DOTATOC和（177）Lu - DOTATOC进行治疗，直至肿瘤进展或出现永久性毒性。采用多变量Cox回归分析来研究生存预测因素。
总体而言，对34例患者进行了74个治疗周期。23例患者病情稳定。3例患者出现严重血液毒性，1例患者出现严重肾毒性。从招募时起平均生存期为8.6年。治疗后病情稳定（风险比，与疾病进展相比为0.017；95%置信区间，0.001 - 0.35；n = 34；P = 0.01）和肿瘤摄取高（风险比，与中等或低肿瘤摄取相比为0.046；95%置信区间，0.004 - 0.63；n = 34；P = 0.019）与更长的生存期相关。
（90）Y - DOTATOC和（177）Lu - DOTATOC是治疗进行性不可切除脑膜瘤的有前景的工具，尤其是在肿瘤中示踪剂摄取高的情况下。
