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01.09.2009 | Original Article | Ausgabe 9/2009

European Journal of Nuclear Medicine and Molecular Imaging 9/2009

Peptide receptor radionuclide therapy with 90Y-DOTATOC in recurrent meningioma

Zeitschrift:
European Journal of Nuclear Medicine and Molecular Imaging > Ausgabe 9/2009
Autoren:
Mirco Bartolomei, Lisa Bodei, Concetta De Cicco, Chiara Maria Grana, Marta Cremonesi, Edoardo Botteri, Silvia Melania Baio, Demetrio Aricò, Maddalena Sansovini, Giovanni Paganelli

Abstract

Purpose

Meningiomas are generally benign and in most cases surgery is curative. However, for high-grade histotypes or partially resected tumours, recurrence is fairly common. External beam radiation therapy (EBRT) is usually given in such cases but is not always effective. We assessed peptide receptor radionuclide therapy (PRRT) using 90Y-DOTATOC in a group of patients with meningioma recurring after standard treatments in all of whom somatostatin receptors were strongly expressed on meningioma cell surfaces.

Methods

Twenty-nine patients with scintigraphically proven somatostatin subtype 2 receptor-positive meningiomas were enrolled: 14 had benign (grade I), 9 had atypical (grade II) and 6 had malignant (grade III) disease. Patients received intravenous 90Y-DOTATOC for 2–6 cycles for a cumulative dose in the range of 5–15 GBq. Clinical and neuroradiological evaluations were performed at baseline, during and after PRRT.

Results

The treatment was well tolerated in all patients. MRI 3 months after treatment completion showed disease stabilization in 19 of 29 patients (66%) and progressive disease in the remaining 10 (34%). Better results were obtained in patients with grade I meningioma than in those with grade II–III, with median time to progression (from beginning PRRT) of 61 months in the low-grade group and 13 months in the high-grade group.

Conclusion

PRRT with 90Y-DOTATOC can interfere with the growth of meningiomas. The adjuvant role of this treatment, soon after surgery, especially in atypical and malignant histotypes, deserves further investigation.

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