Pelle Eleonora, Al-Toubah Taymeyah, El-Haddad Ghassan, Morse Brian, Konda Bhavana, Sukrithan Vineeth, Strosberg Jonathan
Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Department of Diagnostic Imaging and Interventional Radiology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Endocr Oncol. 2025 Jul 7;5(1):e250033. doi: 10.1530/EO-25-0033. eCollection 2025 Jan.
Lutetium-177 (Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in Lu-DOTATATE-treated patients.
Clinical records were reviewed of patients with midgut NETs treated with Lu-DOTATATE at the Moffitt Cancer Center between April 2018 and December 2022 and at The Ohio State University between December 2017 and October 2020.
Among the cases reviewed, we identified three patients who developed bowel ischemia/perforation shortly after their initial treatment with Lu-DOTATATE. All patients had metastatic small bowel NET with prominent mesenteric mass encasing/obstructing the mesenteric vessels and preexisting symptoms of postprandial abdominal pain.
Acute bowel ischemia may be a rare complication of PRRT in patients with mesenteric arterial or venous obstruction from mesenteric metastasis.
镥-177（Lu）-奥曲肽是转移性胃肠胰神经内分泌肿瘤（GEP-NETs）的有效治疗方法。然而，辐射可导致肿瘤短暂性炎症/肿胀，进而引发毒性反应。与肠系膜或腹膜疾病相关的治疗相关小肠梗阻已有报道。我们研究了接受Lu-奥曲肽治疗的患者发生肠缺血的可能性。
回顾了2018年4月至2022年12月在莫菲特癌症中心以及2017年12月至2020年10月在俄亥俄州立大学接受Lu-奥曲肽治疗的中肠神经内分泌肿瘤患者的临床记录。
在回顾的病例中，我们确定了3例患者在首次接受Lu-奥曲肽治疗后不久发生肠缺血/穿孔。所有患者均患有转移性小肠神经内分泌肿瘤，伴有包裹/阻塞肠系膜血管的明显肠系膜肿块，并伴有餐后腹痛的既往症状。
对于因肠系膜转移导致肠系膜动脉或静脉梗阻的患者，急性肠缺血可能是肽受体放射性核素治疗（PRRT）的一种罕见并发症。
