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European Journal of Nuclear Medicine and Molecular Imaging

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21.05.2018 | Review Article

Correlation of dose with toxicity and tumour response to ⁹⁰Y- and ¹⁷⁷Lu-PRRT provides the basis for optimization through individualized treatment planning

verfasst von: Marta Cremonesi, Mahila Esmeralda Ferrari, Lisa Bodei, Carlo Chiesa, Anna Sarnelli, Cristina Garibaldi, Massimiliano Pacilio, Lidia Strigari, Paul Eugene Summers, Roberto Orecchia, Chiara Maria Grana, Francesca Botta

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 13/2018

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Abstract

Purpose

Peptide receptor radionuclide therapy (PRRT) with ⁹⁰Y-labelled and ¹⁷⁷Lu-labelled peptides is an effective strategy for the treatment of metastatic/nonresectable neuroendocrine tumours (NETs). Dosimetry provides important information useful for optimizing PRRT with individualized regimens to reduce toxicity and increase tumour responses. However, this strategy is not applied in routine clinical practice, despite the fact that several dosimetric studies have demonstrated significant dose–effect correlations for normal organ toxicity and tumour response that can better guide therapy planning. The present study reviews the key relationships and the radiobiological models available in the literature with the aim of providing evidence that optimization of PRRT is feasible through the implementation of dosimetry.

Methods

The MEDLINE database was searched combining specific keywords. Original studies published in the English language reporting dose–effect outcomes in patients treated with PRRT were chosen.

Results

Nine of 126 studies were selected from PubMed, and a further five were added manually, reporting on 590 patients. The studies were analysed and are discussed in terms of weak and strong elements of correlations.

Conclusion

Several studies provided evidence of clinical benefit from the implementation of dosimetry in PRRT, indicating the potential contribution of this approach to reducing severe toxicity and/or reducing undertreatment that commonly occurs. Prospective trials, possibly multicentre, with larger numbers of patients undergoing quantitative dosimetry and with standardized methodologies should be carried out to definitively provide robust predictive paradigms to establish effective tailored PRRT.

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Titel: Correlation of dose with toxicity and tumour response to 90Y- and 177Lu-PRRT provides the basis for optimization through individualized treatment planning
verfasst von: Marta Cremonesi
Mahila Esmeralda Ferrari
Lisa Bodei
Carlo Chiesa
Anna Sarnelli
Cristina Garibaldi
Massimiliano Pacilio
Lidia Strigari
Paul Eugene Summers
Roberto Orecchia
Chiara Maria Grana
Francesca Botta
Publikationsdatum: 21.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 13/2018
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-4044-x

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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