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European Journal of Nuclear Medicine and Molecular Imaging

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01.02.2014 | Original Article

Outcome and toxicity of salvage therapy with ¹⁷⁷Lu-octreotate in patients with metastatic gastroenteropancreatic neuroendocrine tumours

verfasst von: Amir Sabet, Torjan Haslerud, Ulrich-Frank Pape, Amin Sabet, Hojjat Ahmadzadehfar, Frank Grünwald, Stefan Guhlke, Hans-Jürgen Biersack, Samer Ezziddin

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2014

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Abstract

Purpose

We assessed the outcome and toxicity of salvage therapy (repeat treatment) with ¹⁷⁷Lu-octreotate and high cumulative activities in patients with metastatic gastroenteropancreatic neuroendocrine tumours (GEP-NET).

Methods

We retrospectively analysed a consecutive cohort of 33 patients with metastatic GEP-NET who underwent salvage peptide receptor radionuclide therapy (PRRT) in our institution. All patients had progressive NET prior to salvage treatment and had shown an initial response to PRRT. The mean cumulative activity was 44.3 GBq (30.0–83.7 GBq). Radiographic response was assessed using CT and/or MRI according to modified SWOG criteria. Toxicity was evaluated using laboratory data, including complete blood counts and renal function tests using CTCAE 3.0. Survival analysis was performed with the Kaplan-Meier curve method and a significance level at p < 0.05.

Results

Radiographic responses consisted of complete response in 1 patient (3.0 %), partial response in 6 patients (18.2 %), minor response in 1 patient (3.0 %), stable disease in 14 patients (42.4 %), and progressive disease in 11 patients (33.3 %). Median progression-free survival (PFS) from the start of salvage therapy was 13 months (95 % CI 9–18) and patients with a history of a durable PFS after initial PRRT tended to have long-lasting PFS after salvage treatment (p = 0.04). None of the patients developed severe nephrotoxicity (grade 3/4) or a myelodysplastic syndrome during follow-up. Relevant albeit reversible haematotoxicity (grade 3/4) occurred in 7 patients (21.2 %). The cumulative administered activity was not associated with an increased incidence of haematotoxicity.

Conclusion

PRRT with ¹⁷⁷Lu-octreotate in the re-treatment setting is safe and effective in patients with metastatic GEP-NET.

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Titel: Outcome and toxicity of salvage therapy with 177Lu-octreotate in patients with metastatic gastroenteropancreatic neuroendocrine tumours
verfasst von: Amir Sabet
Torjan Haslerud
Ulrich-Frank Pape
Amin Sabet
Hojjat Ahmadzadehfar
Frank Grünwald
Stefan Guhlke
Hans-Jürgen Biersack
Samer Ezziddin
Publikationsdatum: 01.02.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2014
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2547-z

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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