肽受体放射性核素治疗及¹³¹I-间碘苄胍在转移性/进展性嗜铬细胞瘤和副神经节瘤患者管理中的应用
Peptide Receptor Radionuclide Treatment and (131)I-MIBG in the management of patients with metastatic/progressive phaeochromocytomas and paragangliomas.
作者信息
Nastos Konstantinos, Cheung Vincent T F, Toumpanakis Christos, Navalkissoor Shaunak, Quigley Anne-Marie, Caplin Martyn, Khoo Bernard
机构信息
ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK.
Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK.
出版信息
J Surg Oncol. 2017 Mar;115(4):425-434. doi: 10.1002/jso.24553. Epub 2017 Feb 6.
BACKGROUND AND OBJECTIVES
Radionuclide therapy has been used to treat patients with progressive/metastatic paragangliomas (PGLs) and phaeochromocytomas (PCCs). The aim of the present study is to retrospectively compare the therapeutic outcomes of these modalities in patients with progressive/metastatic PCCs and PGLs.
METHODS
Patients with progressive/metastatic PGLs and PCCs that were subjected to radionuclide treatment in our department were retrieved from our department's database for the period 1998-2013. Overall survival (OS), progression free survival (PFS), event free survival (EFS), and response to treatment were calculated. Treatment toxicity was documented.
RESULTS
Twenty-two patients with progressive/metastatic PGLs or PCCs were treated with either (131)I-MIBG, (90)Y-DOTATATE or (177)Lu-DOTATATE. A total of 30 treatments were administered (16 treatments with (131)I-MIBG, 2 with (177)Lu-DOTATATE, and 12 with (90)Y-DOTATATE. Patients treated with PRRT had increased PFS and response to treatment compared to (131)I-MIBG treated patients (P < 0.05). However, difference in OS was non significant (P = 0.09). There was no difference in major toxicities between groups. When comparing only patients with PGLs, OS, PFS, EFS, and response to treatment were significantly higher in the PRRT treatment group.
CONCLUSION
PRRT treatment offers increased OS, PFS, EFS, and response to treatment compared to (131)I-MIBG therapy in patients with progressive/malignant PGLs.
背景与目的
放射性核素治疗已用于治疗进展期/转移性副神经节瘤（PGLs）和嗜铬细胞瘤（PCCs）患者。本研究的目的是回顾性比较这些治疗方式对进展期/转移性PCCs和PGLs患者的治疗效果。
方法
从我科1998年至2013年的数据库中检索接受放射性核素治疗的进展期/转移性PGLs和PCCs患者。计算总生存期（OS）、无进展生存期（PFS）、无事件生存期（EFS）和治疗反应。记录治疗毒性。
结果
22例进展期/转移性PGLs或PCCs患者接受了（131）I - MIBG、（90）Y - DOTATATE或（177）Lu - DOTATATE治疗。共进行了30次治疗（16次（131）I - MIBG治疗、2次（177）Lu - DOTATATE治疗和12次（90）Y - DOTATATE治疗）。与接受（131）I - MIBG治疗的患者相比，接受肽受体放射性核素治疗（PRRT）患者的PFS和治疗反应有所增加（P < 0.05）。然而，OS差异无统计学意义（P = 0.09）。两组之间的主要毒性无差异。仅比较PGLs患者时，PRRT治疗组的OS、PFS、EFS和治疗反应明显更高。
结论
与（131）I - MIBG治疗相比，PRRT治疗可提高进展期/恶性PGLs患者的OS、PFS、EFS和治疗反应。
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