Peptide Receptor Radionuclide Treatment and (131)I-MIBG in the management of patients with metastatic/progressive phaeochromocytomas and paragangliomas.
OBJECTIVE
Radionuclide therapy has been used to treat patients with progressive/metastatic paragangliomas (PGLs) and phaeochromocytomas (PCCs). The aim of the present study is to retrospectively compare the therapeutic outcomes of these modalities in patients with progressive/metastatic PCCs and PGLs.


METHODS
Patients with progressive/metastatic PGLs and PCCs that were subjected to radionuclide treatment in our department were retrieved from our department's database for the period 1998-2013. Overall survival (OS), progression free survival (PFS), event free survival (EFS), and response to treatment were calculated. Treatment toxicity was documented.


RESULTS
Twenty-two patients with progressive/metastatic PGLs or PCCs were treated with either (131)I-MIBG, (90)Y-DOTATATE or (177)Lu-DOTATATE. A total of 30 treatments were administered (16 treatments with (131)I-MIBG, 2 with (177)Lu-DOTATATE, and 12 with (90)Y-DOTATATE. Patients treated with PRRT had increased PFS and response to treatment compared to (131)I-MIBG treated patients (P < 0.05). However, difference in OS was non significant (P = 0.09). There was no difference in major toxicities between groups. When comparing only patients with PGLs, OS, PFS, EFS, and response to treatment were significantly higher in the PRRT treatment group.


CONCLUSIONS
PRRT treatment offers increased OS, PFS, EFS, and response to treatment compared to (131)I-MIBG therapy in patients with progressive/malignant PGLs.
ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK.
Konstantinos
K
Nastos
ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK.
Vincent T F
VTF
Cheung
ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK.
Christos
C
Toumpanakis
Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK.
Shaunak
S
Navalkissoor
Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK.
Anne-Marie
AM
Quigley
ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK.
Martyn
M
Caplin
ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK.|Department of Endocrinology, Royal Free London NHS Foundation Trust, London, UK.
Bernard
B
Khoo
D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D058186:Acute Kidney Injury / Q000209:etiology; D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010235:Paraganglioma / Q000401:mortality / Q000628:therapy*; D010673:Pheochromocytoma / Q000401:mortality / Q000628:therapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012189:Retrospective Studies; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; D019797:3-Iodobenzylguanidine; C496730:90Y-octreotide, DOTA-Tyr(3)-; C447941:lutetium Lu 177 dotatate; D015282:Octreotide
(131)I-MIBG; paraganglioma; peptide receptor radionuclide treatment; phaeochromocytoma; radionuclide therapy