Opalińska Marta, Sowa-Staszczak Anna, Grochowska Anna, Olearska Helena, Hubalewska-Dydejczyk Alicja
Nuclear Medicine Unit, Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Kraków, Poland.
Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland.
Front Oncol. 2021 Nov 12;11:687925. doi: 10.3389/fonc.2021.687925. eCollection 2021.
Neuroendocrine neoplasms including neuroendocrine tumors (NETs) are often diagnosed as primary disseminated or inoperable. In those cases, systemic extensive therapy is necessary, but radical treatment is unlikely. As described in the literature, in some selected cases, peptide receptor radionuclide therapy (PRRT) may be used as a first-line/neoadjuvant therapy that allows further successful surgery. Such treatment may enable a reduction of total tumor burden or allow a radical treatment which improves the final outcomes.
This study aims to assess whether neoadjuvant PRRT could be a treatment option for patients with initially unresectable NETs.
Among the group of 114 patients treated with PRRT between the years 2005 and 2020, in 32 cases, it was the first-line therapy, mainly due to massive disease burden at the time of diagnosis. Among them, nine patients received PRRT as the first-line treatment due to the primary inoperable tumors with the intention of preoperative reduction of the tumor size in order to allow for a surgical treatment.
Neoadjuvant PRRT enabled surgery in four out of nine (45%) patients. Finally, in two out of four cases, the goal (radical surgery) has been achieved.
PRRT may be considered not only as a palliative but also as a neoadjuvant therapy in advanced, somatostatin-positive NETs that were initially inoperable.
神经内分泌肿瘤（NETs）等神经内分泌肿瘤通常被诊断为原发性播散性或无法手术切除。在这些情况下，全身广泛治疗是必要的，但根治性治疗不太可能。如文献所述，在某些特定病例中，肽受体放射性核素治疗（PRRT）可作为一线/新辅助治疗，从而使进一步的成功手术成为可能。这种治疗可能会减轻肿瘤总负荷，或实现根治性治疗，从而改善最终结果。
本研究旨在评估新辅助PRRT是否可作为初始不可切除NETs患者的一种治疗选择。
在2005年至2020年间接受PRRT治疗的114例患者中，有32例为一线治疗，主要是因为诊断时疾病负担较重。其中，9例患者因原发性不可手术肿瘤接受PRRT作为一线治疗，目的是术前缩小肿瘤大小以便进行手术治疗。
新辅助PRRT使9例患者中的4例（45%）能够接受手术。最终，4例中有2例实现了目标（根治性手术）。
对于最初无法手术的晚期、生长抑素阳性NETs，PRRT不仅可被视为姑息性治疗，也可被视为新辅助治疗。
