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European Journal of Nuclear Medicine and Molecular Imaging

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04.10.2016 | Original Article

Long-term follow-up and role of FDG PET in advanced pancreatic neuroendocrine patients treated with ¹⁷⁷Lu-D OTATATE

verfasst von: Maddalena Sansovini, Stefano Severi, Annarita Ianniello, Silvia Nicolini, Lorenzo Fantini, Emilio Mezzenga, Fabio Ferroni, Emanuela Scarpi, Manuela Monti, Alberto Bongiovanni, Sara Cingarlini, Chiara Maria Grana, Lisa Bodei, Giovanni Paganelli

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 3/2017

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Abstract

Purpose

Lu-DOTATATE (Lu-PRRT) is a valid therapeutic option in differentiated pancreatic neuroendocrine tumors (P-NETs). FDG PET seems to be an important prognostic factor in P-NETs. We evaluated the efficacy of Lu-PRRT and the role of FDG PET in 60 patients with advanced P-NETs.

Methods

From March 2008 to June 2011, 60 consecutive patients with P-NETs were enrolled in the study. Follow-up lasted until March 2016. Eligible patients were treated with two different total cumulative activities (18.5 or 27.8 GBq in 5 cycles every 6–8 weeks), according to kidney and bone marrow parameters.

Results

Twenty-eight patients received a mean full activity (FA) of 25.9 GBq and 32 a mean reduced activity (RA) of 18.5 GBq. The disease control rate (DCR), defined as the sum of CR+PR+SD was 85.7 % in the FA group and 78.1 % in the RA group. Median progression-free survival (mPFS) was 53.4 months in the FA group and 21.7 months in the RA group (P = 0.353). Median overall survival (mOS) was not reached (nr) in FA patients and was 63.8 months in the RA group (P = 0.007). Fifty-five patients underwent an FDG PET scan before Lu-PRRT, 32 (58 %) showing an increased FDG uptake in tumor sites. mPFS was 21.1 months in FDG PET-positive patients and 68.7 months in the FDG PET-negative group (P < 0.0002), regardless of the total activity administered.

Conclusion

Both FA and RA are active in patients undergoing Lu-PRRT. However, an FA of 27.8 GBq of Lu-PRRT prolongs PFS and OS compared to an RA of 18.5 GBq. Our results indicate that FDG PET is an independent prognostic factor in this patient setting.

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Titel: Long-term follow-up and role of FDG PET in advanced pancreatic neuroendocrine patients treated with 177Lu-D OTATATE
verfasst von: Maddalena Sansovini
Stefano Severi
Annarita Ianniello
Silvia Nicolini
Lorenzo Fantini
Emilio Mezzenga
Fabio Ferroni
Emanuela Scarpi
Manuela Monti
Alberto Bongiovanni
Sara Cingarlini
Chiara Maria Grana
Lisa Bodei
Giovanni Paganelli
Publikationsdatum: 04.10.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 3/2017
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-016-3533-z

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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