Department for General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Department for Hemato-Oncology, University Hospital of Cologne, Univeristy of Cologne, Cologne, Germany.
Endocrine. 2020 Oct;70(1):187-193. doi: 10.1007/s12020-020-02341-1. Epub 2020 May 17.
In this study, we describe our experience with peptide receptor radionuclide therapy (PRRT) for initially unresectable liver disease as a two-steps therapeutic strategy, first in neoadjuvant intention before surgery and then later on in case of disease relapse.
We performed a retrospective evaluation of four cases of unresectable liver metastases of NET of different origins treated with neoadjuvant Lu-177-DotaTATE for conversion into resectability first and as rechallenging treatment after disease relapse.
After treatment with Lu-177-DotaTAE, resectability was reached in three of four cases. In one case, SIRT was additionally performed preoperatively. Relapse occurred in three of four cases after 32, 34, and 37 months, respectively, and was managed with Re-PRRT-treatment.
Although more data are needed, our retrospective study suggests that treatment with Lu-177-DotaTATE is an important adjunct to surgery not only in neoadjuvant intention but also for treating disease relapse. A register study might deliver more evidence for supporting this strategy.
本研究描述了我们采用肽受体放射性核素治疗（PRRT）对初始不可切除肝脏疾病进行两步治疗策略的经验，首先是在手术前进行新辅助治疗，然后在疾病复发时进行治疗。
我们对 4 例不同起源的神经内分泌肿瘤（NET）不可切除肝转移患者进行了回顾性评估，这些患者采用 Lu-177-DotaTATE 进行新辅助治疗，以实现可切除性，并在疾病复发后进行再挑战治疗。
在接受 Lu-177-DotaTAE 治疗后，4 例中有 3 例达到了可切除性。其中 1 例在术前还进行了 SIRT。4 例中有 3 例分别在 32、34 和 37 个月后复发，并接受了 Re-PRRT 治疗。
尽管还需要更多的数据，但我们的回顾性研究表明，Lu-177-DotaTATE 治疗不仅在新辅助治疗中，而且在治疗疾病复发时，都是手术的重要辅助手段。注册研究可能会提供更多支持这种策略的证据。
