Octreoscan in association with 16-MDCT and neuroendocrine tumor markers in the management and therapeutical stratification of GEP tumor patients

Abstract

1551

Objectives: Cold somatostain analogs (SA) therapy represents one of the treatment of choice for inoperable Neuroendocrine gastroenteropancreatic tumors (NeGEP), with two purposes: to control symptoms and tumor proliferation. Octreoscan (O) plays an important role to plane the management of pts with NeGEP. Aim of this work was to compare accuracy of O alone or in association with CT and serum levels of neuroendocrine tumor markers (NeMT) such CgA, NSE and 5HIAA and to evaluate the impact on quality of life with SA treatment.

Methods: We submitted 33 pts with primary NeGEP tumors from foregut (18/33),from midgut (12/33) and from hindgut (3/33) to O,CT and NeMT before and after a long acting SA treatment done for a mean of 17 months. Performance status was assessed by WHO/ECOG criteria before and after therapy. All pts were i.v. injected with 185 MBq of 111In-Pentetreotide. 4, 24 and 48 hours whole body and abdomen O SPECT scan was done.

Results: O diagnosed primary tumors or metastatic lesion in 21 and was truly negative in 9 pts. Both the results were in agreement with CT and NeMT. O resulted false negative in 3 pts when compared with CT and NeMT levels. Similarly CT and CgA were, in six other pts, false positive and false negative, respectively. All the pts treated with SA showed performance status improvement. In the pts that had normalization of O and CT scan after biotheraphy,also NeMT lowered within normal limits.

Conclusions: We showed a significant improvement of accuracy to detect NeGEP by combining O,CT and NeMT and their association allows to select people to administrate Somatostatin analogs, able to improve quality of life through a control of symptoms and tumor growth stabilization.