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1
Phase 3 Trial of Lu-Dotatate for Midgut Neuroendocrine Tumors.镥[177Lu]奥曲肽治疗中肠神经内分泌肿瘤的3期试验
N Engl J Med. 2017 Jan 12;376(2):125-135. doi: 10.1056/NEJMoa1607427.
2
ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site.ENETS关于肠道、胰腺、支气管神经内分泌肿瘤（NEN）及原发部位不明的NEN远处转移疾病管理的共识指南更新
Neuroendocrinology. 2016;103(2):172-85. doi: 10.1159/000443167. Epub 2016 Jan 5.
3
Metastatic Insulinoma Pancreatic Neuroendocrine Tumor Treated With 177Lu-DOTATATE Induction and Maintenance Peptide Receptor Radionuclide Therapy: A Suggested Protocol.转移性胰岛素瘤胰腺神经内分泌肿瘤经 177Lu-DOTATATE 诱导和维持肽受体放射性核素治疗：建议方案。
Clin Nucl Med. 2016 Jan;41(1):53-4. doi: 10.1097/RLU.0000000000001023.
4
Management of endocrine disease: a clinical update on tumor-induced hypoglycemia.内分泌疾病的管理：肿瘤诱导性低血糖的临床最新进展。
Eur J Endocrinol. 2014 Mar 14;170(4):R147-57. doi: 10.1530/EJE-13-1012. Print 2014 Apr.
5
Metastatic insulinoma managed with radiolabeled somatostatin analog.采用放射性标记生长抑素类似物治疗转移性胰岛素瘤。
Case Rep Endocrinol. 2013;2013:252159. doi: 10.1155/2013/252159. Epub 2013 Dec 17.
6
Improved control of severe hypoglycemia in patients with malignant insulinomas by peptide receptor radionuclide therapy.通过肽受体放射性核素治疗改善恶性胰岛素瘤患者严重低血糖的控制。
J Clin Endocrinol Metab. 2011 Nov;96(11):3381-9. doi: 10.1210/jc.2011-1563. Epub 2011 Sep 14.
7
Therapies for the medical management of persistent hypoglycaemia in two cases of inoperable malignant insulinoma.两例无法手术的恶性胰岛素瘤患者持续性低血糖的医学治疗。
Eur J Endocrinol. 2010 May;162(5):1001-8. doi: 10.1530/EJE-09-1010. Epub 2010 Feb 17.
8
Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0,Tyr3]octreotate: toxicity, efficacy, and survival.用放射性标记的生长抑素类似物[177 Lu-DOTA 0，Tyr3]奥曲肽进行治疗：毒性、疗效和生存期。
J Clin Oncol. 2008 May 1;26(13):2124-30. doi: 10.1200/JCO.2007.15.2553.
9
Recurrent hyperinsulinemic hypoglycemia caused by an insulin-secreting insulinoma.由分泌胰岛素的胰岛素瘤引起的复发性高胰岛素血症性低血糖症。
Nat Clin Pract Endocrinol Metab. 2006 Aug;2(8):467-70; quiz following 470. doi: 10.1038/ncpendmet0263.

镥[177Lu]奥曲肽对恶性胰岛素瘤相关严重难治性低血糖的长期影响。

LONG-TERM EFFECT OF LU-DOTATATE ON SEVERE AND REFRACTORY HYPOGLYCEMIA ASSOCIATED WITH MALIGNANT INSULINOMA.

作者信息

Iglesias Pedro, Martínez Alberto, Gajate Pablo, Alonso Teresa, Navarro Teresa, Díez Juan J

出版信息

AACE Clin Case Rep. 2019 Jun 26;5(6):e330-e333. doi: 10.4158/ACCR-2019-0086. eCollection 2019 Nov-Dec.

DOI:10.4158/ACCR-2019-0086
PMID:31967064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6873842/
Abstract

OBJECTIVE

Malignant insulinoma is an extremely uncommon tumor that is usually accompanied by severe hypoglycemia that is difficult to manage. At this time, the long-term effect of Lu-DOTATATE (lutetium [Lu-177]-DOTA-Tyr3-octreotate) on this tumor is not well known.

METHODS

We report a case of severe, life-threatening, and refractory hypoglycemia associated with malignant insulinoma treated with Lu-DOTATATE.

RESULTS

A 51-year-old woman was referred because of severe, life-threatening, and refractory hypoglycemia due to malignant insulinoma. The patient had been treated unsuccessfully with chemotherapy, targeted therapies, and symptomatic therapy with diazoxide, steroids, and somatostatin analogues without success. Lu-DOTATATE adequately controlled her hypoglycemia after the other conventional treatments failed.

CONCLUSION

Lu-DOTATATE was effective in providing rapid and long-term symptomatic control of the hypoglycemia and significantly improved the quality of life of the patient.

摘要

目的

恶性胰岛素瘤是一种极为罕见的肿瘤，通常伴有难以控制的严重低血糖。目前，镥-多他肽（镥[Lu-177]-多他肽-酪氨酰3-奥曲肽）对该肿瘤的长期疗效尚不清楚。

方法

我们报告一例用镥-多他肽治疗的与恶性胰岛素瘤相关的严重、危及生命且难治性低血糖病例。

结果

一名51岁女性因恶性胰岛素瘤导致严重、危及生命且难治性低血糖前来就诊。该患者接受化疗、靶向治疗以及用二氮嗪、类固醇和生长抑素类似物进行对症治疗均未成功。在其他常规治疗失败后，镥-多他肽充分控制了她的低血糖。

结论

镥-多他肽能有效快速且长期地对症控制低血糖，并显著改善患者的生活质量。