Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Center for Rare Diseases - Reference Center Northern Bavaria (ZESE), Würzburg, Germany.
Theranostics. 2018 Jan 1;8(3):644-649. doi: 10.7150/thno.22161. eCollection 2018.
Sarcoidosis is a multisystem granulomatous disorder of unknown etiology that can involve virtually all organ systems. Whereas most patients present without symptoms, progressive and disabling organ failure can occur in up to 10% of subjects. Somatostatin receptor (SSTR)-directed peptide receptor radionuclide therapy (PRRT) has recently received market authorization for treatment of SSTR-positive neuroendocrine tumors. We describe the first case series comprising two patients with refractory multi-organ involvement of sarcoidosis who received 4 cycles of PRRT. PRRT was well-tolerated without any acute adverse effects. No relevant toxicities could be recorded during follow-up. Therapy resulted in partial response accompanied by a pronounced reduction in pain (patient #1) and stable disease regarding morphology as well as disease activity (patient #2), respectively. Peptide receptor radionuclide therapy in sarcoidosis is feasible and might be a new valuable tool in patients with otherwise treatment-refractory disease. Given the long experience with and good tolerability of PRRT, further evaluation of this new treatment option for otherwise treatment-refractory sarcoidosis in larger patient cohorts is warranted.
结节病是一种病因不明的多系统肉芽肿性疾病，几乎可以累及所有器官系统。虽然大多数患者无症状，但多达 10%的患者可能会出现进行性和致残性器官衰竭。生长抑素受体（SSTR）导向的肽受体放射性核素治疗（PRRT）最近已获得治疗 SSTR 阳性神经内分泌肿瘤的市场批准。我们描述了两例接受 4 个周期 PRRT 治疗的难治性多器官结节病患者的首例病例系列。PRRT 耐受性良好，无任何急性不良反应。在随访期间未记录到任何相关毒性。治疗后分别伴有疼痛显著减轻（患者 #1）和形态及疾病活动度稳定的部分缓解（患者 #2）。肽受体放射性核素治疗结节病是可行的，可能是治疗抵抗性疾病患者的一种新的有价值的工具。鉴于 PRRT 的长期经验和良好耐受性，有必要在更大的患者队列中进一步评估这种新的治疗选择对治疗抵抗性结节病的疗效。
