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- Title
Clinical results of radionuclide therapy of neuroendocrine tumours with Y-DOTATATE and tandem Y/Lu-DOTATATE: which is a better therapy option?
- Authors
Kunikowska, Jolanta; Królicki, Leszek; Hubalewska-Dydejczyk, Alicja; Mikołajczak, Renata; Sowa-Staszczak, Anna; Pawlak, Dariusz
- Abstract
Purpose: Peptide receptor radionuclide therapy (PRRT) using radiolabelled somatostatin analogues is a treatment option for patients with disseminated neuroendocrine tumours (NET). A combination treatment using the high-energy Y beta emitter for larger lesions and the lower energy Lu for smaller lesions has been postulated in the literature.The aim of the study was to evaluate combined Y/Lu-DOTATATE therapy in comparison to Y-DOTATATE alone. Methods: Fifty patients with disseminated NET were included in the study prospectively and divided into two groups: group A ( n = 25) was treated with Y-DOTATATE, whereas group B ( n = 25) received the 1:1 Y/Lu-DOTATATE. The administered activity was based on 3.7 GBq/m body surface area in three to five cycles, with amino acid infusion for nephroprotection. Results: The median overall survival time in group A was 26.2 months while in group B median survival was not reached. Overall survival was significantly higher in group B ( p = 0.027). Median event-free survival time in group A was 21.4 months and in group B 29.4 months ( p > 0.1). At the 12-month follow-up, comparison of group A vs group B showed stable disease (SD) in 13 vs 16 patients, disease regression (RD) in 5 vs 3 patients and disease progression (PD) in 3 vs 4 patients; 4 and 2 patients died, respectively. The 24-month follow-up results were SD in nine vs ten patients, RD in one patient vs none and PD in four patients in both groups; three and four patients died, respectively. Side effects were rare and mild. Conclusion: The results indicate that therapy with tandem radioisotopes (Y/Lu-DOTATATE) provides longer overall survival than with a single radioisotope (Y-DOTATATE) and the safety of both methods is comparable.
- Subjects
RADIOISOTOPES; NEUROENDOCRINE tumors; SOMATOSTATIN; LIVER diseases; BONE metastasis
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2011, Vol 38, Issue 10, p1788
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-011-1833-x