Love Charito, Desai Neil B, Abraham Tony, Banks Kevin P, Bodei Lisa, Boike Thomas, Brown Richard K J, Bushnell David L, DeBlanche Lorraine E, Dominello Michael M, Francis Tony, Grady Erin C, Hobbs Robert F, Hope Thomas A, Kempf Jeffrey S, Pryma Daniel A, Rule William, Savir-Baruch Bital, Sethi Ila, Subramaniam Rathan M, Xiao Ying, Schechter Naomi R
Albert Einstein College of Medicine, New York.
New York Cancer and Blood Specialists, Port Jefferson Station, NY.
Am J Clin Oncol. 2022 Jun 1;45(6):233-242. doi: 10.1097/COC.0000000000000903. Epub 2022 May 4.
This practice parameter (PP) for Lutetium-177 (Lu-177) DOTATATE peptide receptor radionuclide therapy (PRRT) aims to guide authorized users in selection of appropriate adult candidates with gastroeneropancreatic neuroendocrine tumors (GEP-NETs) from foregut, midgut, and hindgut. The essential selection criteria include somatostatin receptor-positive GEP-NETs, which are usually inoperable and progressed despite standard therapy. Lu-177 DOTATATE is a radiopharmaceutical with high avidity for somatostatin receptors that are overexpressed by these tumors. This document ensures safe handling of Lu-177 DOTATATE by the authorized users and safe management of affected patients.
The document was developed according to the systematic process developed by the American College of Radiology (ACR) and described on the ACR Web site (https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards). The PP development was led by 2 ACR Committees on Practice Parameters (Nuclear Medicine and Molecular Imaging and Radiation Oncology) collaboratively with the American College of Nuclear Medicine, American Society of Radiation Oncology, and Society of Nuclear Medicine and Molecular Imaging.
The Lu-177 DOTATATE PP reviewed pharmacology, indications, adverse effects, personnel qualifications, and required clinical evaluation before starting the treatment, as well as the recommended posttherapy monitoring, quality assurance, documentation, and appropriate radiation safety instructions provided in written form and explained to the patients.
Lu-177 DOTATATE is available for therapy of inoperable and/or advanced GEP-NETs when conventional therapy had failed. It can reduce tumor size, improve symptoms, and increase the progression free survival. The PP document provides clinical guidance for authorized users to assure an appropriate, consistent, and safe practice of Lu-177 DOTATATE.
本关于镥-177（Lu-177）奥曲肽肽受体放射性核素治疗（PRRT）的实践参数（PP）旨在指导授权使用者从前肠、中肠和后肠中选择合适的患有胃肠胰神经内分泌肿瘤（GEP-NETs）的成年患者。基本选择标准包括生长抑素受体阳性的GEP-NETs，这些肿瘤通常无法手术切除且尽管接受了标准治疗仍有进展。Lu-177奥曲肽是一种对这些肿瘤过度表达的生长抑素受体具有高亲和力的放射性药物。本文档确保授权使用者安全处理Lu-177奥曲肽，并对受影响患者进行安全管理。
该文档是根据美国放射学会（ACR）制定并在ACR网站（https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards）上描述的系统流程制定的。PP的制定由ACR两个实践参数委员会（核医学与分子影像和放射肿瘤学）与美国核医学学会、美国放射肿瘤学会以及核医学与分子影像学会合作牵头。
Lu-177奥曲肽PP回顾了药理学、适应症、不良反应、人员资质以及治疗开始前所需的临床评估，以及推荐的治疗后监测、质量保证、文档记录，并以书面形式提供并向患者解释了适当的辐射安全说明。
当传统治疗失败时，Lu-177奥曲肽可用于治疗无法手术切除和/或晚期GEP-NETs。它可以缩小肿瘤大小、改善症状并延长无进展生存期。PP文档为授权使用者提供临床指导，以确保Lu-177奥曲肽的适当、一致和安全应用。
