Erschienen in:
06.06.2018 | Gastrointestinal
CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold?
verfasst von:
Yanji Luo, Jie Chen, Bingqi Shen, Meng Wang, Huasong Cai, Ling Xu, Luohai Chen, Minhu Chen, Zi-Ping Li, Shi-Ting Feng
Erschienen in:
European Radiology
|
Ausgabe 12/2018
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Abstract
Objective
To identify a reliable early indicator of deriving progression-free survival (PFS) benefit in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with octreotide long-acting repeatable (LAR).
Methods
We investigated the images of 50 patients with well-differentiated advanced GEP-NETs treated with LAR octreotide and underwent baseline and follow-up thoracic, abdominal, and pelvic computed tomography. Receiver-operating characteristic (ROC) analysis and the Kaplan-Meier method were used to identify the optimal threshold to distinguish between those with and without significant improvement of PFS.
Results
The optimal threshold for determining a response to octreotide LAR was -10% ΔSLD, with a sensitivity and specificity of 85.7% and 80%, respectively. At this threshold, 19 patients were responders and 31 were non-responders; the median PFS was 20.2 and 7.6 months in responders and non-responders (hazard ratio, 2.66; 95% confidence interval, 1.32–5.36).
Conclusion
A 10% shrinkage in tumor size is an optimal early predictor of response to octreotide LAR in advanced GEP-NETs.
Key points
• Octreotide LAR can significantly prolong PFS among patients with well-differentiated advanced GEP-NETs.
• No optimal tumor size-based response criteria are reported in GEP-NETs with octreotide.
• Ten percent tumor shrinkage is a reliable indicator of the response to octreotide for advanced GEP-NETs.