Sharma Nancy, Naraev Boris G, Engelman Eric G, Zimmerman M Bridget, Bushnell David L, OʼDorisio Thomas M, OʼDorisio M Sue, Menda Yusuf, Müller-Brand Jan, Howe James R, Halfdanarson Thorvardur R
From the *Division of Hematology, Oncology, and Bone and Marrow Transplantation and the Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA; †Banner MD Anderson Cancer Center, Gilbert, AZ; ‡Medical Associates Clinic, Dubuque; and §Department of Biostatistics, College of Public Health, University of Iowa; ∥Department of Radiology, University of Iowa Hospitals and Clinics; ¶Iowa City Veterans Administration Medical Center; #Division of Endocrinology and Metabolism and the Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics; and **Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA; ††Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland; ‡‡Division of Surgical Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA; and §§Division of Medical Oncology, Mayo Clinic Rochester, Rochester, MN.
Pancreas. 2017 Feb;46(2):151-156. doi: 10.1097/MPA.0000000000000734.
The objective of this study was to describe the outcomes of patients in the University of Iowa Neuroendocrine Tumor (NET) Database treated with peptide receptor radionuclide therapy (PRRT).
One hundred thirty-five patients from the University of Iowa NET Database who received PRRT were analyzed, their characteristics were described, and survival was calculated.
The median age at diagnosis was 51 years, and 64% were men. The primary tumor was located in the small bowel (SBNET) in 37.8%, in the pancreas (PNET) in 26.0%, in the lung in 13.3%, in unknown primary in 9.6%, and in other sites in 13.3%. A radiographic response of any magnitude was observed in 65.8%, 11.1% had a mixed response, and 15.4% showed progression. The overall survival (OS) from the first PRRT was 40 months, and the median time to progression was 23.9 months. Higher pretreatment chromogranin A and pancreastatin levels predicted inferior OS.
Peptide receptor radionuclide therapy resulted in a relatively long OS and time to progression in heavily pretreated North American patients with advanced NETs. Elevated pretreatment chromogranin A and pancreastatin predicted shorter OS after therapy. Peptide receptor radionuclide therapy is a valuable treatment option in patients with advanced NETs, especially SBNETS.
本研究的目的是描述爱荷华大学神经内分泌肿瘤(NET)数据库中接受肽受体放射性核素治疗(PRRT)的患者的治疗结果。
对爱荷华大学NET数据库中135例接受PRRT的患者进行分析,描述其特征并计算生存率。
诊断时的中位年龄为51岁,64%为男性。原发肿瘤位于小肠(SBNET)的占37.8%,位于胰腺(PNET)的占26.0%,位于肺部的占13.3%,原发灶不明的占9.6%,位于其他部位的占13.3%。观察到任何程度影像学反应的患者占65.8%,有混合反应的占11.1%,病情进展的占15.4%。首次PRRT后的总生存期(OS)为40个月,中位疾病进展时间为23.9个月。治疗前嗜铬粒蛋白A和胰抑制素水平较高预示着较差的总生存期。
肽受体放射性核素治疗使经过大量预处理的北美晚期NET患者的总生存期和疾病进展时间相对延长。治疗前嗜铬粒蛋白A和胰抑制素水平升高预示着治疗后总生存期较短。肽受体放射性核素治疗是晚期NET患者,尤其是SBNETS患者的一种有价值的治疗选择。