Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
European Journal of Nuclear Medicine and Molecular Imaging
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 10/2008

01.10.2008 | Original Article

Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: the role of associated risk factors

verfasst von: Lisa Bodei, Marta Cremonesi, Mahila Ferrari, Monica Pacifici, Chiara M. Grana, Mirco Bartolomei, Silvia M. Baio, Maddalena Sansovini, Giovanni Paganelli

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 10/2008

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumours with 90Y-DOTATOC and 177Lu-DOTATATE is promising. The kidney is the critical organ and despite renal protection, function loss may become evident years later. The aim of this study was to analyse renal parameters in patients who had undergone dosimetry before PRRT.

Methods

Among those in protocols at our institution, 28 patients were considered: 23 received 90Y-DOTATOC (3.8–29.2 GBq, median 12.2) and five received 177Lu-DOTATATE (20.7–29.2 GBq, median 23.2). Patients were followed up after therapy for creatinine and creatinine clearance loss (CCL) for 3–97 months (median 30). Renal doses and bio-effective doses (BED) were calculated (MIRD, LQ model).

Results

After 90Y-DOTATOC toxicity on creatinine according to NCI criteria occurred in nine cases (seven grade 1, one grade 2, one grade 3), CCL at 1 year was >5% in 12 cases and >10% in eight. A 28-Gy BED threshold was observed in patients with risk factors (mainly hypertension and diabetes), while it was 40 Gy in patients without risk factors. Probably due to the low number of patients, despite the absence of severe toxicity after hyper-fractionated PRRT, clear correlations between fractionation and toxicity could not be found. After 177Lu-DOTATATE, no toxicity occurred in 1–2 year follow-up; CCL at 1 year >5% occurred in three patients and >10% in two.

Conclusions

Our results indicate the importance of clinical screening for risk factors: In this case, a BED <28 Gy is recommended. Fractionation of therapy is important in order to decrease toxicity, and further studies are needed to evaluate its clinical impact.
Literatur
1.
de Jong M, Valkema R, Jamar F, Kvols LK, Kwekkeboom DJ, Breeman WA, et al. Somatostatin receptor-targeted radionuclide therapy of tumors: preclinical and clinical findings. Semin Nucl Med 2002;32(2):133–40.PubMedCrossRef
2.
Waldherr C, Pless M, Maecke HR, Schumacher T, Crazzolara A, Nitzsche EU, et al. Tumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq (90)Y-DOTATOC. J Nucl Med 2002;43(5):610–6.PubMed
3.
Bodei L, Cremonesi M, Grana C, Rocca P, Bartolomei M, Chinol M, et al. Receptor radionuclide therapy with 90Y-[DOTA]0-Tyr3-octreotide (90Y-DOTATOC) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging 2004;31(7):1038–46.PubMedCrossRef
4.
Kwekkeboom DJ, Mueller-Brand J, Paganelli G, Anthony LB, Pauwels S, Kvols LK, et al. Overview of results of peptide receptor radionuclide therapy with 3 radiolabeled somatostatin analogs. J Nucl Med 2005;46(Suppl 1):62S–6S.PubMed
5.
Valkema R, de Jong M, Bakker WH, Breeman WA, Kooij PP, Lugtenburg PJ, et al. Phase I study of peptide receptor radionuclide therapy with [In-DTPA]octreotide: the Rotterdam experience. Semin Nucl Med 2002;32(2):110–22.PubMedCrossRef
6.
Kwekkeboom DJ, Teunissen JJ, Bakker WH, Kooij PP, de Herder WW, Feelders RA, et al. Radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate in patients with endocrine gastroenteropancreatic tumors. J Clin Oncol 2005;23(12):2754–62.PubMedCrossRef
7.
Bernard BF, Krenning EP, Breeman WA, Rolleman EJ, Bakker WH, Visser TJ, et al. d-lysine reduction of indium-111 octreotide and yttrium-90 octreotide renal uptake. J Nucl Med 1997;38(12):1929–33.PubMed
8.
de Jong M, Krenning EP. New advances in peptide receptor radionuclide therapy. J Nucl Med 2002;43(5):617–20.PubMed
9.
Paganelli G, Zoboli S, Cremonesi M, Bodei L, Ferrari M, Grana C, et al. Receptor-mediated radiotherapy with 90Y-DOTA-d-Phe1-Tyr3-octreotide. Eur J Nucl Med 2001;28(4):426–34.PubMedCrossRef
10.
Bodei L, Cremonesi M, Zoboli S, Grana C, Bartolomei M, Rocca P, et al. Receptor-mediated radionuclide therapy with 90Y-DOTATOC in association with amino acid infusion: a phase I study. Eur J Nucl Med Mol Imaging 2003;30(2):207–16.PubMed
11.
Bodei L, Cremonesi M, Grana C, Bartolomei M, Baio SM, Bufi G, et al. Receptor radionuclide therapy with 177Lu-DOTATATE in neuroendocrine tumours. Eur J Nucl Med Mol Imaging 2006;33(Suppl 2):S214.
12.
13.
Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function: measured and estimated glomerular filtration rate. N Engl J Med 2006;354:2473–83.PubMedCrossRef
14.
Al-Said J, Brumback MA, Moghazi S, Baumgarten DA, O'Neill WC. Reduced renal function in patients with simple renal cysts. Kidney Int 2004;65(6):2303–8.PubMedCrossRef
15.
Yamazaki H, Oi H, Matsushita M, Kim T, Tanaka E, Inoue T, et al. Renal cortical retention on delayed CT and nephropathy following transcatheter arterial chemoembolisation. Br J Radiol 2001;74(884):695–700.PubMed
16.
Yao X, Panichpisal K, Kurtzman N, Nugent K. Cisplatin nephrotoxicity: a review. Am J Med Sci 2007;334(2):115–24.PubMedCrossRef
17.
Savi A, Lecchi M, Albertini F, Chiesa C, Gilardi MC, Bombardieri E, et al. Evaluation of attenuation correction in planar In-111 biodistribution studies [abstract]. Eur J Nucl Med Mol Imaging 2004;31(Suppl):S229.
18.
Cremonesi M, Ferrari M, Bodei L, Tosi G, Paganelli G. Dosimetry in peptide radionuclide receptor therapy: a review. J Nucl Med 2006;47(9):1467–75.PubMed
19.
Cremonesi M, Ferrari M, Bodei L, Bartolomei M, Chinol M, Mei R, et al. Dosimetry in patients undergoing 177Lu-DOTATATE therapy with indications for 90Y-DOTATATE. Eur J Nucl Med Mol Imaging 2006;33(Suppl 1):S102. Abs 91.
20.
Siegel JA, Thomas SR, Stubbs JB, Stabin MG, Hays MT, Koral KF, et al. Techniques for quantitative radiopharmaceutical biodistribution data acquisition and analysis for use in human radiation dose estimates: MIRD pamphlet no16. J Nucl Med 1999;40(2):S37–S61.
21.
22.
Stabin MG, Sparks RB, Crowe E. OLINDA/EXM: the second-generation personal computer software for internal dose assessment in nuclear medicine. J Nucl Med 2005;46:1023–27.PubMed
23.
Foster D, Barret P (editors). Developing and testing integrated multicompartment models to describe a single-input multiple-output study using the SAAM II software system. In: Proceedings of the Sixth International Radiopharmaceutical Dosimetry Symposium. Oak Ridge, Tennessee: Oak Ridge Institute for Science and Education;1998.
24.
Dale R. Use of the linear-quadratic radiobiological model for quantifying kidney response in targeted radiotherapy. Cancer Biother Radiopharm 2004;19(3):363–70.PubMedCrossRef
25.
Thames HD, Ang KK, Stewart FA, van der Schueren E. Does incomplete repair explain the apparent failure of the basic LQ model to predict spinal cord and kidney responses to low doses per fraction? Int J Radiat Biol 1988;54(1):13–9.PubMedCrossRef
26.
Barone R, Borson-Chazot F, Valkema R, Walrand S, Chauvin F, Gogou L, et al. Patient-specific dosimetry in predicting renal toxicity with (90)Y-DOTATOC: relevance of kidney volume and dose rate in finding a dose–effect relationship. J Nucl Med 2005;46(Suppl 1):99S–106S.PubMed
27.
Cybulla M, Weiner SM, Otte A. End-stage renal disease after treatment with 90Y-DOTATOC. Eur J Nucl Med 2001;28(10):1552–4.PubMedCrossRef
28.
Otte A, Herrmann R, Heppeler A, Behe M, Jermann E, Powell P, et al. Yttrium-90 DOTATOC: first clinical results. Eur J Nucl Med 1999;26(11):1439–47.PubMedCrossRef
29.
Valkema R, Pauwels SA, Kvols LK, Kwekkeboom DJ, Jamar F, de Jong M, et al. Long-term follow-up of renal function after peptide receptor radiation therapy with (90)Y-DOTA(0),Tyr(3)-octreotide and (177)Lu-DOTA(0), Tyr(3)-octreotate. J Nucl Med 2005;46(Suppl 1):83S–91S.PubMed
30.
National Council on Radiation Protection and Measurements. Misadministration of radioactive material in medicine–scientific background. Bethesda, MD 1991:27
31.
Cassady JR. Clinical radiation nephropathy. Int J Radiat Oncol Biol Phys 1995;31(5):1249–56.PubMed
32.
Cremonesi M, Ferrari M, Zoboli S, Chinol M, Stabin MG, Orsi F, et al. Biokinetics and dosimetry in patients administered with 111In-DOTA-Tyr3-octreotide: implications for internal radiotherapy with 90Y-DOTATOC. Eur J Nucl Med 1999;26:877–86.PubMedCrossRef
33.
Walrand S, Jamar F, Mathieu I, De Camps J, Lonneux M, Sibomana M, et al. Quantitation in PET using isotopes emitting prompt single gammas: application to yttrium-86. Eur J Nucl Med Mol Imaging 2003;30:354–61.PubMed
34.
Dale R, Carabe-Fernandez A. The radiobiology of conventional radiotherapy and its application to radionuclide therapy. Cancer Biother Radiopharm 2005;20(1):47–51.PubMedCrossRef
Metadaten
Titel
Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: the role of associated risk factors
verfasst von
Lisa Bodei
Marta Cremonesi
Mahila Ferrari
Monica Pacifici
Chiara M. Grana
Mirco Bartolomei
Silvia M. Baio
Maddalena Sansovini
Giovanni Paganelli
Publikationsdatum
01.10.2008
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 10/2008
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-008-0778-1

Weitere Artikel der Ausgabe 10/2008

European Journal of Nuclear Medicine and Molecular Imaging 10/2008 Zur Ausgabe

Review Article

Diagnostic accuracy of integrated FDG-PET/contrast-enhanced CT in staging ovarian cancer: comparison with enhanced CT

Erratum

Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: the role of associated risk factors

Original Article

Selective hepatic arterial infusion of In-111-DTPA-Phe1-octreotide in neuroendocrine liver metastases

Original Article

Non-invasive estimation of hepatic blood perfusion from H2 15O PET images using tissue-derived arterial and portal input functions

Original Article

Macrocyclic chelator-coupled gastrin-based radiopharmaceuticals for targeting of gastrin receptor-expressing tumours

Editorial Commentary

Therapy options for treatment of hepatic malignancy