Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022 Jan-Feb;41(1):55-65. doi: 10.1016/j.remnie.2021.11.001. Epub 2021 Dec 14.
This continuing education aims to present in a clear and easy-to-understand way, the biology of neuroendocrine tumors (NETs), the characteristics of somatostatin receptors, the selection of patients for radiolabelled peptide therapy (PRRT), the inclusion criteria to benefit from treatment with the minimum possible adverse effects, the administration protocol, follow-up and response evaluation. The functional imaging studies necessary to explore the biology of the tumor and to individualize the treatment are also carried out, and constitute the cornerstone for the development of teragnosis. Clinical trials are being developed to better define the position of PRRT within the broad therapeutic options, and among the future perspectives, there are several lines of research to improve the objective response rate and survival with PRRT, focused on the development of new agonists and somatostatin receptor antagonists, new radionuclides and radiosensitizing combination therapies. In conclusion, PRRT is a great therapeutic, well-tolerated and safe tool with generally mild and self-limited acute side effects, that must be sequenced at the best moment of the evolution of the disease of patients with NET. Candidate patients for PRRT should always be evaluated by a multidisciplinary clinical committee.
本继续教育旨在以清晰易懂的方式介绍神经内分泌肿瘤（NET）的生物学、生长抑素受体的特征、放射性肽治疗（PRRT）患者的选择、受益于治疗的纳入标准（尽可能减少不良反应）、给药方案、随访和反应评估。还进行了探索肿瘤生物学和个体化治疗所需的功能成像研究，这是开发治疗诊断学的基石。正在开展临床试验，以更好地确定 PRRT 在广泛治疗选择中的地位，未来的研究方向包括几条旨在提高 PRRT 的客观缓解率和生存率的研究路线，重点是开发新的激动剂和生长抑素受体拮抗剂、新的放射性核素和放射增敏联合治疗。总之，PRRT 是一种疗效好、耐受性好且安全的治疗工具，一般具有轻微且自限性的急性副作用，必须在 NET 患者疾病进展的最佳时机进行排序。PRRT 的候选患者应由多学科临床委员会进行评估。
