Peptide receptor radionuclide therapy for neuroendocrine tumors in Germany: first results of a multi-institutional cancer registry.
Peptide receptor radionuclide therapy is an effective treatment option for patients with well-differentiated somatostatin receptor-expressing neuroendocrine tumors. However, published data result mainly from retrospective monocentric studies. We initiated a multi-institutional, prospective, board-reviewed registry for patients treated with peptide receptor radionuclide therapy in Germany in 2009. In five centers, 297 patients were registered. Primary tumors were mainly derived from pancreas (117/297) and small intestine (80/297), whereas 56 were of unknown primary. Most tumors were well differentiated with median Ki67 proliferation rate of 5% (range 0.9-70%). Peptide receptor radionuclide therapy was performed using mainly yttrium-90 and/or lutetium-177 as radionuclides in 1-8 cycles. Mean overall survival was estimated at 213 months with follow-up between 1 and 230 months after initial diagnosis, and 87 months with follow-up between 1 and 92 months after start of peptide receptor radionuclide therapy. Median overall survival was not yet reached. Subgroup analysis demonstrated that best results were obtained in neuroendocrine tumors with proliferation rate below 20%. Our results indicate that peptide receptor radionuclide therapy is an effective treatment for well- and moderately differentiated neuroendocrine tumors irrespective of previous therapies and should be regarded as one of the primary treatment options for patients with somatostatin receptor-expressing neuroendocrine tumors.
Department of Gastroenterology and Endocrinology, Center of Neuroendocrine Tumors Bad Berka-ENETS Center of Excellence, Bad Berka, Germany. dieter.hoersch@zentralklinik.de
Dieter
D
Hörsch
Samer
S
Ezziddin
Alexander
A
Haug
Klaus Friedrich
KF
Gratz
Simone
S
Dunkelmann
Bernd Joachim
BJ
Krause
Carl
C
Schümichen
Frank M
FM
Bengel
Wolfram H
WH
Knapp
Peter
P
Bartenstein
Hans-Jürgen
HJ
Biersack
Ursula
U
Plöckinger
Sabine
S
Schwartz-Fuchs
R P
RP
Baum
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008187:Lutetium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000401:mortality / Q000532:radiotherapy*; D011446:Prospective Studies; D011868:Radioisotopes / Q000627:therapeutic use*; D017481:Receptors, Somatostatin / Q000032:analysis*; D012042:Registries; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D011868:Radioisotopes; D017481:Receptors, Somatostatin; D015021:Yttrium Radioisotopes; D008187:Lutetium