Su Dan, Yang Hongyu, Qiu Chen, Chen Yue
Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China.
Front Oncol. 2023 Jul 6;13:1141648. doi: 10.3389/fonc.2023.1141648. eCollection 2023.
Peptide receptor radionuclide therapy (PRRT) for advanced pheochromocytomas and paragangliomas (PPGLs) has received increasing attention. The purpose of this article is to evaluate the efficacy and safety of PRRT in patients with metastatic or inoperable PPGLs by meta-analysis.
A literature search was conducted in PubMed, Embase, Scopus, and Cochrane Library databases up to November 2022. All articles on PRRT for PPGLs were searched, and appropriate data were included for analysis. The measures evaluated included objective response rate (ORR), disease control rate (DCR), clinical response rate, biochemical response rate, progression-free survival (PFS), overall survival (OS), and adverse events. Statistical analysis was performed using Stata 16.0 and the R programming language, data were combined using a random-effects model, and the results were presented using forest plots.
A total of 20 studies with 330 patients were included in the analysis. The results showed that ORR and DCR were 20.0% (95% CI: 12.0%-28.0%) and 90.0% (95% CI: 85.0%-95.0%), respectively. Clinical and biochemical responses were 74.9% (95% CI: 56.3%-90.2%) and 69.5% (95%CI: 40.2%-92.9%). Median PFS and median OS were 31.79 (95% CI:21.25-42.33) months and 74.30 (95% CI: 0.75-147.84) months, respectively. Any grade of hematotoxicity and nephrotoxicity occurred in 22.3% (95% CI:12.5%-33.5%) and 4.3% (95% CI:0.2%-11.4%) patients. Grade 3-4 hemotoxicity occurred in 4.3% (95% CI:0.2%-11.4%) and grade 3-4 nephrotoxicity in 4/212 patients. Additionally, Treatment was discontinued in 9.0% (95% CI: 0.5%-23.3%) patients and one patient died as a result of a toxicity.
Patients with metastatic or inoperable PPGLs can be effectively treated with PRRT, and it has a favorable safety profile.
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022359232.
肽受体放射性核素治疗（PRRT）用于晚期嗜铬细胞瘤和副神经节瘤（PPGLs）已受到越来越多的关注。本文旨在通过荟萃分析评估PRRT对转移性或不可切除PPGLs患者的疗效和安全性。
截至2022年11月，在PubMed、Embase、Scopus和Cochrane图书馆数据库中进行文献检索。检索所有关于PRRT治疗PPGLs的文章，并纳入合适的数据进行分析。评估的指标包括客观缓解率（ORR）、疾病控制率（DCR）、临床缓解率、生化缓解率、无进展生存期（PFS）、总生存期（OS）和不良事件。使用Stata 16.0和R编程语言进行统计分析，数据采用随机效应模型合并，并使用森林图展示结果。
共纳入20项研究，330例患者。结果显示，ORR和DCR分别为20.0%（95%CI：12.0%-28.0%）和90.0%（95%CI：85.0%-95.0%）。临床和生化缓解率分别为74.9%（95%CI：56.3%-90.2%）和69.5%（95%CI：40.2%-92.9%）。中位PFS和中位OS分别为31.79（95%CI：21.25-42.33）个月和74.30（95%CI：0.75-147.84）个月。22.3%（95%CI：12.5%-33.5%）的患者发生任何级别的血液毒性和肾毒性，4.3%（95%CI：0.2%-11.4%）的患者发生3-4级血液毒性，212例患者中有4例发生3-4级肾毒性。此外，9.0%（95%CI：0.5%-23.3%）的患者停止治疗，1例患者因毒性死亡。
转移性或不可切除的PPGLs患者可通过PRRT得到有效治疗，且安全性良好。
