Maqsood Muhammad Haisum, Tameez Ud Din Asim, Khan Ameer H
Epidemiology and Public Health, King Edward Medical University / Mayo Hospital, Lahore, PAK.
Internal Medicine, Rawalpindi Medical College, Rawalpindi, PAK.
Cureus. 2019 Jan 30;11(1):e3986. doi: 10.7759/cureus.3986.
The worldwide incidence of neuroendocrine tumors (NETs) has been increasing. They are a very diverse group of tumors which are commonly found in the gastrointestinal and bronchopulmonary tracts. These tumors usually express somatostatin receptors. Therefore, somatostatin analogs are used for symptom relief as well as treatment. Of the many therapeutic options available, peptide receptor radionuclide therapy (PRRT) has been shown to be very promising. In January 2018, the Food Drug and Authority (FDA) approved Lu-Dotatate for use in gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Lutetium is a lower energy beta-emitting radionuclide. The therapeutic use of lutetium- (Lu) has shown better results in advanced gastroenteropancreatic and bronchial neuroendocrine tumors when compared with other therapies available. Adverse effects associated with this therapy include myelotoxicity and nephrotoxicity as the radiopeptides are reabsorbed and accumulate in the renal interstitium. Everolimus is a good and safe option in patients pretreated with Lu-Dotatate. Lutetium, in combination with somatostatin analogs, has proven efficacy to treat gastroenteropancreatic neuroendocrine tumors in candidates with somatostatin receptor-positive advanced tumors and normal renal function. This therapy has great potential as it decreases tumor size, improves symptoms, and improves quality of life.
神经内分泌肿瘤（NETs）的全球发病率一直在上升。它们是一组非常多样化的肿瘤，常见于胃肠道和支气管肺脏。这些肿瘤通常表达生长抑素受体。因此，生长抑素类似物用于缓解症状以及治疗。在众多可用的治疗选择中，肽受体放射性核素治疗（PRRT）已显示出非常有前景。2018年1月，美国食品药品监督管理局（FDA）批准镥[177Lu] DOTATATE用于胃肠胰神经内分泌肿瘤（GEP-NETs）。镥是一种低能β发射放射性核素。与其他可用疗法相比，镥（[177Lu]）的治疗应用在晚期胃肠胰和支气管神经内分泌肿瘤中显示出更好的效果。与该疗法相关的不良反应包括骨髓毒性和肾毒性，因为放射性肽会被重吸收并积聚在肾间质中。依维莫司对于接受过镥[177Lu] DOTATATE预处理的患者是一种良好且安全的选择。镥与生长抑素类似物联合使用，已证明对生长抑素受体阳性的晚期肿瘤且肾功能正常的候选患者治疗胃肠胰神经内分泌肿瘤有效。这种疗法具有很大的潜力，因为它可以减小肿瘤大小、改善症状并提高生活质量。
