Peptide Receptor Radionuclide Therapy with radiolabelled somatostatin analogues in patients with somatostatin receptor positive tumours

摘要: Peptide Receptor Radionuclide Therapy (PRRT) with radiolabelled somatostatin analogues is a promising treatment option for patients inoperable or metastasised neuroendocrine tumours. Symptomatic improvement may occur all of the various (111)In, (90)Y, (177)Lu-labelled that have been used. Since tumour size reduction was seldom achieved (111)Indium labelled analogues, beta-emitting isotopes like (90)Y and (177)Lu were developed. Reported anti-tumour effects [(90)Y-DOTA(0),Tyr(3)]octreotide vary considerably between studies: Tumour regression 50% more in 9 to 33% (mean 22%). With [(177)Lu-DOTA(0),Tyr(3)]octreotate treatments, 28% 25 19% patients, stable disease demonstrated 35% progressive 18%. Predictive factors remission high uptake on receptor scintigraphy limited amount liver metastases. The side-effects PRRT are few mostly mild, certainly when using renal protective agents: Serious myelodysplastic syndrome failure rare. median duration therapy response 30 months than 36 respectively. Lastly, quality life improves significantly after [(177)Lu-DOTA(0),Tyr(3)]octreotate. These data compare favourably number alternative approaches, chemotherapy. If widespread use possible, such might become first choice gastroenteropancreatic Also role expressing non-GEP tumours, paraganglioma/pheochromocytoma non-radioiodine-avid differentiated thyroid carcinoma important.