title: Targeted radiotherapy with radiolabeled somatostatin analogs.
abstract: Targeted radiopeptide therapy with (90)Yttrium- or (177)Lutetium-labeled somatostatin analogs has been proven to improve significantly quality of life and survival in patients suffering from metastatic or unresectable neuroendocrine tumors (NETs). Roughly 25% of patients achieve partial remission; progression-free survival is estimated to be 30 to 40 months. A wide range of protocols using different somatostatin analogs, isotopes, injected activity per cycle of administration, and number of cycles are reported. More patient-based therapy protocols are under development, taking into consideration the complexity of NET cell biology, dosimetric issues, and the availability of different radiolabeled analogs. This article reviews the effectiveness and safety of the different protocols and discusses several clinical algorithms used in an attempt to optimize targeted radiopeptide therapy.
authors.affiliation: Department of Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Nicolas
authors.forename: Giampiero
authors.initials: G
authors.lastname: Giovacchini
authors.forename: Jan
authors.initials: J
authors.lastname: Müller-Brand
authors.forename: Flavio
authors.initials: F
authors.lastname: Forrer
mesh_terms: D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D006801:Humans; D007205:Indium Radioisotopes / Q000627:therapeutic use; D008187:Lutetium / Q000627:therapeutic use; D058990:Molecular Targeted Therapy / Q000009:adverse effects / Q000379:methods*; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D018579:Patient Selection; D011832:Radiation Injuries / Q000453:epidemiology; D011868:Radioisotopes / Q000627:therapeutic use; D011877:Radionuclide Imaging; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D013004:Somatostatin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: D007205:Indium Radioisotopes; D011868:Radioisotopes; D015021:Yttrium Radioisotopes; D013004:Somatostatin; D008187:Lutetium