University of Texas Southwestern, Dallas, TX.
New York Cancer and Blood Specialists, Port Jefferson Station, NY.
Clin Nucl Med. 2022 Jun 1;47(6):503-511. doi: 10.1097/RLU.0000000000004182.
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）DOTATATE 肽受体放射性核素治疗（PRRT）的实践参数（PP）旨在指导有资质的用户选择适当的成人候选者，这些候选者患有来自前肠、中肠和后肠的胃肠胰腺神经内分泌肿瘤（GEP-NET）。基本选择标准包括生长抑素受体阳性的 GEP-NET，这些肿瘤通常无法手术且尽管经过标准治疗仍在进展。Lu-177 DOTATATE 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。本文件确保有资质的用户安全处理 Lu-177 DOTATATE，并安全管理受影响的患者。
该文件是根据美国放射学院（ACR）开发的系统流程制定的，并在 ACR 网站（https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards）上进行了描述。该 PP 的开发由 2 个 ACR 实践参数委员会（核医学和分子成像以及放射肿瘤学）与美国核医学学院、美国放射肿瘤学会和核医学与分子成像学会合作领导。
Lu-177 DOTATATE PP 审查了药理学、适应证、不良反应、人员资格以及开始治疗前所需的临床评估，以及推荐的治疗后监测、质量保证、文件记录以及以书面形式提供并向患者解释的适当辐射安全说明。
当常规治疗失败时，Lu-177 DOTATATE 可用于治疗无法手术和/或晚期 GEP-NET。它可以缩小肿瘤大小、改善症状并增加无进展生存期。PP 文件为有资质的用户提供了临床指导，以确保 Lu-177 DOTATATE 的适当、一致和安全应用。
