PDF(Pubmed)
Abstract：
UNASSIGNED: We proposed to administer Lu-177-DOTATATE in intra-arterial (IA) mode for higher first-pass localization to somatostatin receptors, higher residence time in liver metastases, and more radiation to tumor. This study aimed at assessing early hematological, renal and hepatotoxicity; and objective response to IA peptide receptor radionuclide therapy (PRRT).
UNASSIGNED: Fourteen patients (4 females and 10 males) were prospectively assessed. 5/14 patients underwent 2 cycles, whereas 3/14 underwent 3 cycles, and 6/14 received 1 cycle of IA PRRT. 200 mCi of Lu-177-DOTATATE was administered in 15-20 min by IA route under angiographic guidance. Patients were asked to follow-up at 4 and 8 weeks with hematological, liver, and renal functional parameters, and Ga-68 DOTATATE positron emission tomography/computed tomography (PET/CT) after 8 weeks. Response was assessed using RECIST 1.1 and EORTC PET criteria.
UNASSIGNED: Safety: 2/14 patients had high total and direct bilirubin, which reverted to normal after IA PRRT. Three patients had low albumin, which improved after 1 cycle. Nine patients showed no worsening of liver function. Two patients showed Grade 1 hematotoxicity which reverted to normal. Five patients showed high creatinine, but preserved glomerular filtration rate and EC clearance. On follow-up at 8 weeks, serum creatinine reverted to normal. Efficacy: In five patients who underwent 2 cycles of IA PRRT, 3 showed partial response (PR) on RECIST 1.1 and partial metabolic response (PMR) on EORTC criteria, whereas 2 showed stable disease (SD). In patients who underwent 3 cycles, 1 showed SD, whereas other patient showed PMR on DOTANOC PET/CT, with PR in size. Among the remaining seven patients, 5 showed PMR, whereas the other 2 showed SD. Thus 9/14 patients showed PR, whereas 5 showed SD on metabolic and size criteria.
UNASSIGNED: IA PRRT is a safe and efficacious approach for the treatment of liver dominant metastatic neuroendocrine tumors.
UNASSIGNED: Fourteen patients (4 females and 10 males) were prospectively assessed. 5/14 patients underwent 2 cycles, whereas 3/14 underwent 3 cycles, and 6/14 received 1 cycle of IA PRRT. 200 mCi of Lu-177-DOTATATE was administered in 15-20 min by IA route under angiographic guidance. Patients were asked to follow-up at 4 and 8 weeks with hematological, liver, and renal functional parameters, and Ga-68 DOTATATE positron emission tomography/computed tomography (PET/CT) after 8 weeks. Response was assessed using RECIST 1.1 and EORTC PET criteria.
UNASSIGNED: Safety: 2/14 patients had high total and direct bilirubin, which reverted to normal after IA PRRT. Three patients had low albumin, which improved after 1 cycle. Nine patients showed no worsening of liver function. Two patients showed Grade 1 hematotoxicity which reverted to normal. Five patients showed high creatinine, but preserved glomerular filtration rate and EC clearance. On follow-up at 8 weeks, serum creatinine reverted to normal. Efficacy: In five patients who underwent 2 cycles of IA PRRT, 3 showed partial response (PR) on RECIST 1.1 and partial metabolic response (PMR) on EORTC criteria, whereas 2 showed stable disease (SD). In patients who underwent 3 cycles, 1 showed SD, whereas other patient showed PMR on DOTANOC PET/CT, with PR in size. Among the remaining seven patients, 5 showed PMR, whereas the other 2 showed SD. Thus 9/14 patients showed PR, whereas 5 showed SD on metabolic and size criteria.
UNASSIGNED: IA PRRT is a safe and efficacious approach for the treatment of liver dominant metastatic neuroendocrine tumors.
摘要：
■我们建议以动脉内（IA）模式施用Lu-177-DOTATATE，以实现对生长抑素受体的较高首过定位，在肝转移中的停留时间更高，和更多的肿瘤辐射。这项研究旨在评估早期血液学，肾和肝毒性；以及对IA肽受体放射性核素治疗（PRRT）的客观反应。
■对14名患者（4名女性和10名男性）进行了前瞻性评估。5/14患者接受2个周期，而3/14经历了3个周期，6/14接受1个周期的IAPRRT。在血管造影指导下，通过IA途径在15-20分钟内给予200mCi的Lu-177-DOTATATE。要求患者在第4周和第8周进行血液学随访，肝脏,和肾功能参数，8周后和Ga-68DOTATATE正电子发射断层扫描/计算机断层扫描（PET/CT）。使用RECIST1.1和EORTCPET标准评估反应。
■安全性：2/14患者总胆红素和直接胆红素高，IAPRRT后恢复正常。三名患者白蛋白低,1个周期后有所改善。9例患者无肝功能恶化。两名患者显示1级血液毒性，恢复正常。五名患者显示高肌酐，但保留了肾小球滤过率和EC清除率。在8周的随访中，血清肌酐恢复正常。疗效：在5例接受2个周期的IAPRRT患者中，3在RECIST1.1上显示部分反应（PR），在EORTC标准上显示部分代谢反应（PMR），而2显示稳定的疾病（SD）。在接受3个周期的患者中，1显示SD，而其他患者在DOTANOCPET/CT上显示PMR，PR的大小。其余7名患者中,5显示PMR，而其他2个显示SD。因此，9/14患者显示PR，而5在代谢和大小标准上显示SD。
■IAPRRT是治疗肝脏显性转移性神经内分泌肿瘤的一种安全有效的方法。
■对14名患者（4名女性和10名男性）进行了前瞻性评估。5/14患者接受2个周期，而3/14经历了3个周期，6/14接受1个周期的IAPRRT。在血管造影指导下，通过IA途径在15-20分钟内给予200mCi的Lu-177-DOTATATE。要求患者在第4周和第8周进行血液学随访，肝脏,和肾功能参数，8周后和Ga-68DOTATATE正电子发射断层扫描/计算机断层扫描（PET/CT）。使用RECIST1.1和EORTCPET标准评估反应。
■安全性：2/14患者总胆红素和直接胆红素高，IAPRRT后恢复正常。三名患者白蛋白低,1个周期后有所改善。9例患者无肝功能恶化。两名患者显示1级血液毒性，恢复正常。五名患者显示高肌酐，但保留了肾小球滤过率和EC清除率。在8周的随访中，血清肌酐恢复正常。疗效：在5例接受2个周期的IAPRRT患者中，3在RECIST1.1上显示部分反应（PR），在EORTC标准上显示部分代谢反应（PMR），而2显示稳定的疾病（SD）。在接受3个周期的患者中，1显示SD，而其他患者在DOTANOCPET/CT上显示PMR，PR的大小。其余7名患者中,5显示PMR，而其他2个显示SD。因此，9/14患者显示PR，而5在代谢和大小标准上显示SD。
■IAPRRT是治疗肝脏显性转移性神经内分泌肿瘤的一种安全有效的方法。
