Alsadik Shahad, Yusuf Siraj, Al-Nahhas Adil
Department of Nuclear Medicine, Hammersmith Hospital, Imperial College NHS Trust, London, United Kingdom.
Curr Radiopharm. 2019;12(2):126-134. doi: 10.2174/1874471012666190201164132.
The incidence of pancreatic Neuroendocrine Tumours (pNETs) has increased considerably in the last few decades. The characteristic features of this tumour and the development of new investigative and therapeutic methods had a great impact on its management.
The aim of this review is to investigate the outcome of Peptide Receptor Radionuclide Therapy (PRRT) in the treatment of pancreatic neuroendocrine tumours.
A comprehensive literature search strategy was used based on two databases (SCOPUS, and PubMed). We considered all studies published in English, evaluating the use of PRRT (177Luteciuim- DOTA-conjugated peptides and 90Yetrium- DOTA- conjugated peptides) in the treatment of pancreatic neuroendocrine tumours as a standalone entity or as a subgroup within the wider category of Gastroenteropancreatic Neuroendocrine Tumours (GEP NETs).
PRRT was found to be an effective treatment modality as a monotherapy or in combination with other therapies in the treatment of non-operable and metastatic pNETs where other options are limited. Complete response was reported to be between 2-6% while partial response was achieved in up to 60% of cases. Survival analysis was also impressive. Progression Free Survival (PFS) reached a mean of 34 months and Overall Survival (OS) of 53 months. PRRT also proved to improve patients' Quality of Life (QoL). Acute and sub-acute side effects like nephrotoxicity and haematotoxicity are usually mild and reversible.
PRRT is well tolerated and effective treatment option for non-operable and/or metastatic pNETs. Side effects are usually mild and reversible. Larger randomized controlled trails need to be done to compare PRRT with other treatment modalities and to provide more detailed guidelines regarding patient selections, the choice of PRRT, follow up and response assessment to maximum potential benefit.
在过去几十年中，胰腺神经内分泌肿瘤（pNETs）的发病率显著上升。该肿瘤的特征以及新的诊断和治疗方法的发展对其治疗产生了重大影响。
本综述旨在研究肽受体放射性核素治疗（PRRT）在胰腺神经内分泌肿瘤治疗中的疗效。
基于两个数据库（SCOPUS和PubMed）采用全面的文献检索策略。我们纳入了所有以英文发表的研究，评估PRRT（177镥 - DOTA偶联肽和90钇 - DOTA偶联肽）作为单一治疗手段或作为胃肠胰神经内分泌肿瘤（GEP NETs）更广泛类别中的一个亚组用于治疗胰腺神经内分泌肿瘤的情况。
在其他选择有限的不可切除和转移性pNETs的治疗中，PRRT被发现是一种有效的治疗方式，可作为单一疗法或与其他疗法联合使用。据报道，完全缓解率在2% - 6%之间，而部分缓解率在高达60%的病例中实现。生存分析结果也令人印象深刻。无进展生存期（PFS）平均达到34个月，总生存期（OS）为53个月。PRRT还被证明可改善患者的生活质量（QoL）。肾毒性和血液毒性等急性和亚急性副作用通常较轻且可逆。
PRRT对于不可切除和/或转移性pNETs是耐受性良好且有效的治疗选择。副作用通常较轻且可逆。需要进行更大规模的随机对照试验，以将PRRT与其他治疗方式进行比较，并就患者选择、PRRT的选择、随访和反应评估提供更详细的指南，以实现最大潜在获益。
