From the Nuclear Medicine Service.
Abdomen Surgery, National Cancer Institute, Rio de Janeiro, Brazil.
Clin Nucl Med. 2024 Oct 1;49(10):917-923. doi: 10.1097/RLU.0000000000005375. Epub 2024 Jul 31.
Well-differentiated neuroendocrine neoplasms (NETs) overexpress the somatostatin receptor, which is the target for the peptide receptor radionuclide therapy (PRRT). NETs have a slow growth rate and can metastasize to liver, bone, and lungs. In NETs patients, liver metastasis is an important prognostic marker because liver failure is one of the most common causes of death in this population. In this regard, we aimed to describe the changes in laboratorial parameters in patients submitted to PRRT with 177 Lu-DOTATATE, focusing on hepatic parameters.
One hundred ten patients treated with 1 to 4 cycles of 7.4 GBq (200 mCi) of 177 Lu-DOTATATE from January 2011 to December 2021 were analyzed in this retrospective observational single-center study. Patients were submitted to blood tests before and after each cycle of PRRT. Laboratory measurements were collected to assess liver function, cholestasis, kidney, and bone marrow function.
In the general population (n = 110), ALP ( P = 0.013) and GGT ( P < 0.001) showed a statistically significant reduction. Patients with high liver disease volume showed a statistically significant reduction in ALT ( P = 0.016), whereas patients with low liver disease volume showed a statistically significant reduction in GGT ( P = 0.013). All parameters for bone marrow function showed a statistically significant decrease in all population subsets.
Patients treated with 177 Lu-DOTATATE showed a significant improvement in liver function and cholestasis parameters, and a consistent decrease in bone marrow function, even in the presence of advanced liver disease.
分化良好的神经内分泌肿瘤 (NET) 过度表达生长抑素受体,这是肽受体放射性核素治疗 (PRRT) 的靶点。NET 生长缓慢,可转移至肝脏、骨骼和肺部。在 NET 患者中,肝转移是一个重要的预后标志物,因为肝功能衰竭是该人群死亡的最常见原因之一。在这方面,我们旨在描述接受 177Lu-DOTATATE 进行 PRRT 的患者的实验室参数变化,重点关注肝脏参数。
本回顾性观察性单中心研究分析了 2011 年 1 月至 2021 年 12 月期间接受 1 至 4 个周期 7.4GBq(200mCi)177Lu-DOTATATE 治疗的 110 例患者。患者在 PRRT 每个周期前后接受血液检查。收集实验室测量值以评估肝功能、胆汁淤积、肾脏和骨髓功能。
在一般人群(n=110)中,碱性磷酸酶(ALP)(P=0.013)和γ-谷氨酰转移酶(GGT)(P<0.001)均显示出统计学上的显著降低。肝脏疾病体积高的患者丙氨酸氨基转移酶(ALT)显著降低(P=0.016),而肝脏疾病体积低的患者 GGT 显著降低(P=0.013)。所有骨髓功能参数在所有人群亚组中均显示出统计学上的显著降低。
接受 177Lu-DOTATATE 治疗的患者肝功能和胆汁淤积参数显著改善,骨髓功能持续下降,即使存在晚期肝病。