Treatment with (90)Y- and (177)Lu-DOTATOC in patients with metastatic neuroendocrine tumors.
BACKGROUND
Treatment with (90)Y- or (177)Lu-DOTATOC has recently been introduced in the palliative treatment of somatostatin receptor-expressing neuroendocrine tumors (NETs). The aim of the study was to present clinical experience with (90)Y- and (177)Lu-DOTATOC therapy in the management of NET.


METHODS
To prove suitability for treatment each patient underwent scanning with (111)In-DTPAOC or (68)Ga-DOTATOC positron emission tomography/computed tomography. All patients received [(90)Y-DOTATOC] as initial treatment. In case of disease relapse the treatment was repeated. To avoid side effects of repeated [(90)Y] applications, a switch to [(177)Lu-DOTATOC] was carried out. Clinical, biochemical, and radioimaging responses were documented.


RESULTS
Twenty patients with metastatic nonresectable NETs (15 pancreas NETs, 2 midgut NETs, 1 gastrinoma, 1 paraganglioma, 1 NET of unknown primary origin) were included. In 8 patients the treatment was repeated more than once (mean, 3 times; range, 2-5 times). After [(90)Y] treatment moderate toxicity was observed in 8 patients. No serious adverse events were documentable. After restaging, a partial remission was found in 5 patients, stable disease in 11 patients, and tumor progression in 4 patients.


CONCLUSIONS
Peptide receptor-targeted radionuclide therapy is a promising, safe, and feasible approach in the palliative therapy of patients with NET.
Frilling
Andrea
A
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Germany. frilling@uni-essen.de
Weber
Frank
F
Saner
Fuat
F
Bockisch
Andreas
A
Hofmann
Michael
M
Mueller-Brand
Jan
J
Broelsch
Christoph E
CE
D000328:Adult; D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy; D008187:Lutetium / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000532:radiotherapy; D049268:Positron-Emission Tomography; D011868:Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use*; D011878:Radiotherapy / Q000379:methods; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*
D011868:Radioisotopes; D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; D008187:Lutetium; D015282:Octreotide; C106246:Edotreotide