Escala Cornejo Roberto A, García-Talavera Paloma, Navarro Martin Miguel, Pérez López Berta, García Muñoz María, Tamayo Alonso Ma Pilar, Cruz Hernández Juan J
Department of Medical Oncology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Department of Nuclear Medicine, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Ann Nucl Med. 2018 Oct;32(8):568-572. doi: 10.1007/s12149-018-1276-6. Epub 2018 Jul 26.
Large cell neuroendocrine carcinoma of the lung (LCNEC) is a high-grade, poorly differentiated tumor that typically does not express somatostatin receptors. Thus, it does not benefit from treatment with somatostatin analogs and peptide receptor radionuclide therapy (PRRT). The current study objective was to demonstrate that treatment with PRRT may be a valid option in neuroendocrine carcinomas with high expression of somatostatin receptors. This is a case report of a 58-year-old man who was diagnosed with LCNEC and received chemotherapy treatment with little benefit. Extensive hepatic and bone metastasis was detected on In-pentetreotide scintigraphy following high uptake of the radionuclide by the tumors. The patient benefitted from neuroendocrine treatment initially and from lutetium Lu 177 dotatate subsequently. A significant clinical and radiological response was observed, along with an improvement in quality of life. The use of PRRT is a valid alternative to chemotherapy in patients with LCNEC involving the expression of somatostin receptors.
肺大细胞神经内分泌癌（LCNEC）是一种高级别、低分化肿瘤，通常不表达生长抑素受体。因此，它无法从生长抑素类似物和肽受体放射性核素治疗（PRRT）中获益。当前研究目的是证明PRRT治疗对于生长抑素受体高表达的神经内分泌癌可能是一种有效的选择。这是一例58岁男性的病例报告，该患者被诊断为LCNEC，接受化疗但获益甚微。肿瘤对放射性核素摄取较高，随后的铟泮替膦酸盐闪烁扫描检测到广泛的肝转移和骨转移。该患者最初从神经内分泌治疗中获益，随后从镥Lu 177奥曲肽治疗中获益。观察到显著的临床和影像学反应，同时生活质量得到改善。对于表达生长抑素受体的LCNEC患者，PRRT的应用是化疗的有效替代方案。
