Hasenauer Natalie, Müller Miriam, Hänscheid Heribert, Serfling Sebastian E, Michalski Kerstin, Heinrich Marieke, Polat Bülent, Buck Andreas K, Werner Rudolf A, Hartrampf Philipp E
Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080, Würzburg, Germany.
Department of Radiation Oncology, University Hospital Wuerzburg, Würzburg, Germany.
Eur J Nucl Med Mol Imaging. 2025 Jun 2. doi: 10.1007/s00259-025-07336-6.
This study evaluates safety and efficacy of peptide receptor radionuclide therapy (PRRT) as a stand-alone treatment for recurrent meningiomas and investigates the prognostic value of laboratory markers and quantitative PET parameters.
The single-center study includes 32 patients with recurrent meningioma, who underwent PRRT with [Lu]Lu-DOTATOC/-TATE. Pre-treatment assessments comprised [ Ga]Ga-DOTATOC PET imaging, routine hematology and serum chemistry analysis. Outcomes including progression-free survival (PFS), overall survival (OS), and treatment related toxicity, were retrospectively evaluated using Kaplan-Meier survival analysis and Cox regression models.
PRRT showed only mild hematological and renal toxicity, with most adverse events being low-grade (87%). OS was significantly shorter in patients with WHO grade III meningiomas (10 months) compared to grade I (not reached, HR 4.77, p < 0.01) and grade II (47 months, HR 4.05, p = 0.01). Similarly, PFS was shorter in patients with WHO grade III meningiomas (4.5 months) compared to grade I (17 months, HR 6.47, p < 0.001) and grade II (17 months, HR 2.71, p = 0.02). In multivariable analysis, only higher WHO grade was an independent predictor of disease progression, while baseline PET and laboratory parameters showed no consistent association. Furthermore, increase of SSTR-positive tumor volume in follow-up PET was associated with shorter PFS (HR 1.02, p = 0.02).
PRRT is a safe treatment option and appears to have a favourable effect in patients with recurrent meningiomas. WHO tumor grade is the strongest predictor of PFS and OS, while baseline PET parameters appear to have no prognostic value.
本研究评估肽受体放射性核素治疗（PRRT）作为复发性脑膜瘤独立治疗方法的安全性和有效性，并研究实验室标志物和PET定量参数的预后价值。
这项单中心研究纳入了32例复发性脑膜瘤患者，他们接受了[镥]镥-多他曲肽/多他特的PRRT治疗。预处理评估包括[镓]镓-多他曲肽PET成像、常规血液学和血清化学分析。使用Kaplan-Meier生存分析和Cox回归模型对无进展生存期（PFS）、总生存期（OS）和治疗相关毒性等结果进行回顾性评估。
PRRT仅显示轻度血液学和肾脏毒性，大多数不良事件为低级别（87%）。与WHO I级（未达到，HR 4.77，p < 0.01）和II级（47个月，HR 4.05，p = 0.01）脑膜瘤患者相比，WHO III级脑膜瘤患者的OS显著缩短（10个月）。同样，与WHO I级（17个月，HR 6.47，p < 0.001）和II级（17个月，HR 2.71，p = 0.02）脑膜瘤患者相比，WHO III级脑膜瘤患者的PFS较短（4.5个月）。在多变量分析中，只有较高的WHO分级是疾病进展的独立预测因素，而基线PET和实验室参数未显示出一致的关联。此外，随访PET中生长抑素受体（SSTR）阳性肿瘤体积增加与较短的PFS相关（HR 1.02，p = 0.02）。
PRRT是一种安全的治疗选择，对复发性脑膜瘤患者似乎有良好疗效。WHO肿瘤分级是PFS和OS的最强预测因素，而基线PET参数似乎没有预后价值。
