Treatment with (90)Y- and (177)Lu-DOTATOC in patients with metastatic neuroendocrine tumors

• Published in: Surgery 2006-12, Vol.140 (6), p.968
• Main Authors: Frilling, Andrea, Weber, Frank, Saner, Fuat, Bockisch, Andreas, Hofmann, Michael, Mueller-Brand, Jan, Broelsch, Christoph E
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Neuroendocrine - pathology; Carcinoma, Neuroendocrine - radiotherapy; Female; Gastrointestinal Neoplasms - pathology; Gastrointestinal Neoplasms - radiotherapy; Humans; Lung Neoplasms - pathology; Lung Neoplasms - radiotherapy; Lutetium - adverse effects; Lutetium - therapeutic use; Male; Middle Aged; Octreotide - adverse effects; Octreotide - analogs & derivatives; Octreotide - therapeutic use; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - radiotherapy; Positron-Emission Tomography; Radioisotopes - adverse effects; Radioisotopes - therapeutic use; Radiopharmaceuticals - adverse effects; Radiopharmaceuticals - therapeutic use; Radiotherapy - methods; Treatment Outcome; Yttrium Radioisotopes - adverse effects; Yttrium Radioisotopes - therapeutic use
• ISSN: 0039-6060
• DOI: 10.1016/j.surg.2006.07.030

Treatment with (90)Y- or (177)Lu-DOTATOC has recently been introduced in the palliative treatment of somatostatin receptor-expressing neuroendocrine tumors (NETs). The aim of the study was to present clinical experience with (90)Y- and (177)Lu-DOTATOC therapy in the management of NET. To prove suitability for treatment each patient underwent scanning with (111)In-DTPAOC or (68)Ga-DOTATOC positron emission tomography/computed tomography. All patients received [(90)Y-DOTATOC] as initial treatment. In case of disease relapse the treatment was repeated. To avoid side effects of repeated [(90)Y] applications, a switch to [(177)Lu-DOTATOC] was carried out. Clinical, biochemical, and radioimaging responses were documented. Twenty patients with metastatic nonresectable NETs (15 pancreas NETs, 2 midgut NETs, 1 gastrinoma, 1 paraganglioma, 1 NET of unknown primary origin) were included. In 8 patients the treatment was repeated more than once (mean, 3 times; range, 2-5 times). After [(90)Y] treatment moderate toxicity was observed in 8 patients. No serious adverse events were documentable. After restaging, a partial remission was found in 5 patients, stable disease in 11 patients, and tumor progression in 4 patients. Peptide receptor-targeted radionuclide therapy is a promising, safe, and feasible approach in the palliative therapy of patients with NET.