Department of Radiology, University Hospital Bonn, Bonn, Germany.
Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany.
Eur J Nucl Med Mol Imaging. 2019 Oct;46(11):2252-2259. doi: 10.1007/s00259-019-04431-3. Epub 2019 Jul 24.
There is convincing evidence that peptide receptor radionuclide therapy (PRRT) using Lu-DOTATATE compared to octreotide therapy has a positive effect on overall survival and progression-free survival in midgut neuroendocrine tumors (NET). The current study analyzed health-related quality of life (QoL) in patients undergoing PRRT with a special focus on differences in functional performance.
In our study, 70 patients (39 men or 31 female) suffering from midgut NET were included, with a mean age of 64.2 years. Functional performance was assessed by the index of the Eastern Cooperative of Oncology Group (ECOG). Thirty-three patients (47%) showed ECOG 0, 31 patients (44%) ECOG 1, and six patients (9%) ECOG 2. Health-related QoL was assessed by the EORTC QLQ-C30 questionnaire filled in at baseline and 3 months after each PRRT cycle.
The median cumulative administered activity was 27.4 GBq. Global health status significantly improved compared to baseline status after 1st (p = 0.05), 2nd (p = 0.004), and 3rd (p = 0.04) treatment cycle. Analyzing specific aspects of QoL, emotional functioning significantly improved after 1st and 2nd treatment cycle (both p < 0.001) as well as after 3rd cycle (p = 0.001). With regard to cognitive functioning, there was a significant improvement after 1st and 2nd treatment cycle (p = 0.003 and p = 0.05 respectively). With regard to alleviation of somatic symptoms, a significant reduction in pain and diarrhea was observed after the 2nd cycle (p = 0.038) and 3rd cycle (p = 0.036). Furthermore, changes in QoL in relation to functional performance status as assessed by ECOG were analyzed. There were no significant differences with regard to QoL alterations between patients with high (ECOG 0 or 1) and moderate performance status.
Our study confirmed an equally positive effect of PRRT on quality of life in midgut NET patients with high or moderate functional status in terms of increasing global health, functional status, and alleviating symptoms.
有确凿证据表明，与奥曲肽治疗相比，使用 Lu-DOTATATE 的肽受体放射性核素治疗（PRRT）对中肠神经内分泌肿瘤（NET）的总生存和无进展生存有积极影响。本研究分析了接受 PRRT 治疗的患者的健康相关生活质量（QoL），特别关注功能表现的差异。
在我们的研究中，纳入了 70 名（39 名男性或 31 名女性）患有中肠 NET 的患者，平均年龄为 64.2 岁。功能性表现通过东部肿瘤合作组织（ECOG）指数进行评估。33 名患者（47%）表现为 ECOG 0，31 名患者（44%）为 ECOG 1，6 名患者（9%）为 ECOG 2。通过 EORTC QLQ-C30 问卷在基线和每次 PRRT 周期后 3 个月进行健康相关 QoL 评估。
中位累积给予的活性为 27.4GBq。与基线状态相比，第 1 次（p=0.05）、第 2 次（p=0.004）和第 3 次（p=0.04）治疗周期后，全球健康状况显著改善。分析 QoL 的特定方面，情感功能在第 1 次和第 2 次治疗周期后显著改善（均 p<0.001），在第 3 次治疗周期后也显著改善（p=0.001）。在认知功能方面，第 1 次和第 2 次治疗周期后有显著改善（p=0.003 和 p=0.05）。在躯体症状缓解方面，第 2 次（p=0.038）和第 3 次（p=0.036）治疗周期后疼痛和腹泻明显减轻。此外，还分析了 ECOG 评估的功能表现状态与 QoL 变化之间的关系。在高（ECOG 0 或 1）和中性能状态的患者中，QoL 改变之间没有显著差异。
我们的研究证实，PRRT 对中肠 NET 患者的生活质量有同样的积极影响，无论其功能状态高低，都能提高整体健康、功能状态和缓解症状。
