title: Metastatic Insulinoma Pancreatic Neuroendocrine Tumor Treated With 177Lu-DOTATATE Induction and Maintenance Peptide Receptor Radionuclide Therapy: A Suggested Protocol.
abstract: A 70-year-old woman presented with frequent episodes of hypoglycemia. Imaging revealed a 6-cm pancreatic mass with several liver lesions. The pancreatic mass was resected and confirmed to be a well-differentiated insulinoma. Surgery improved but did not resolve her hypoglycemic episodes, and she was referred for peptide receptor radionuclide therapy with 177Lu-DOTATATE to treat her residual disease. A modified protocol with a continuous IV dextrose infusion was used, and the treatments were well tolerated. After 4 induction and 2 maintenance treatments, her hypoglycemic symptoms resolved completely and her disease stabilized. She has been progression free for 24 months.
authors.affiliation: From the Department of Diagnostic Imaging, Cross Cancer Institute, Edmonton, Alberta, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Makis
authors.forename: Karey
authors.initials: K
authors.lastname: McCann
authors.forename: Alexander J B
authors.initials: AJ
authors.lastname: McEwan
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000473:pathology / Q000532:radiotherapy*; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000532:radiotherapy*; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D018000:Receptors, Peptide / Q000378:metabolism*
chemical_list: D009942:Organometallic Compounds; D018000:Receptors, Peptide; C447941:lutetium Lu 177 dotatate; D015282:Octreotide