Outcome of peptide receptor radionuclide therapy with 177Lu-octreotate in advanced grade 1/2 pancreatic neuroendocrine tumours.

摘要: The clinical benefit of peptide receptor radionuclide therapy (PRRT) in patients with pancreatic neuroendocrine tumours (pNET) has not yet been well described and defined its full extent due to limited data this tumour subgroup. This study was intended obtain robust, comparative on the outcome toxicity standardized PRRT 177Lu-octreotate a well-characterized population advanced pNET grade 1/2 (G1/2). We retrospectively analysed cohort 68 inoperable metastatic disease consecutively treated (four cycles at 3-monthly intervals; mean activity per cycle 8.0 GBq). Of these patients, 46 (67.6 %) had documented morphological progression during 12 months before initiation treatment, first-line systemic 35 (51.5 %). Response evaluated according modified Southwest Oncology Group (SWOG) criteria additionally Criteria Solid Tumors (RECIST) 1.1. Survival using Kaplan-Meier curves Cox proportional hazards model for univariate multivariate analyses. Toxicity assessed by standard follow-up laboratory work-up including blood count, liver renal function, supplemented serial 99mTc-DTPA clearance measurements. median period 58 months (range 4 – 112). Reversible haematotoxicity (grade 3 or more) occurred four (5.9 %). No significant nephrotoxicity observed. Treatment responses (SWOG criteria) consisted partial response 41 (60.3 %), minor 8 (11.8 %), stable 9 (13.2 %), progressive 10 (14.7 %). Median progression-free survival (PFS) overall (OS) were 34 (95 % CI 26 – 42) 53 months 46 – 60), respectively. A G1 proliferation status associated longer PFS (p = 0.04) OS (p = 0.044) analysis. Variables linked impaired OS, other hand, reduced performance (Karnofsky score ≤70 %, p = 0.007), high hepatic burden (≥25 % volume, p = 0.017), an elevated plasma level neuron-specific enolase (NSE >15 ng/ml, p = 0.035). outstanding rates outcomes suggest that is highly effective G1/2 when compared treatment modalities. Independent predictors are index, patient’s status, baseline NSE level.