Abstract
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Objectives The aim of this study was to assess the efficacy of peptide receptor radionuclide therapy (PRRT) connecting with “cold” long acting somatostatin analogue and the survival rate of patients with disseminated or non-operable neuroendocrine tumours (NETs).
Methods 70 patients were enrolled to the study. The 90Y-DOTATATE therapeutic activity was calculated per total body surface area up to a total of 7.4 GBq/m2 administrated in three to five cycles, repeated every four to nine weeks. After PRRT, patients have been further treated with cold long acting somatostatin analogues (Sandostatin LAR) to the progression of the disease.
Results Out of 70 90Y-DOTATATE treated patients, 22 died after completing the therapy, among them two due to myocardial infarction. After 12 month follow-up, stabilization of disease was observed in 63%, partial remission in 25%, and progression in 12% in this group of patients. The progression free survival (PFS) was found to be 41.27 months and the event-free survival (EFS) - 37.73 months. The median overall survival (OS) was not reached. According to the literature (Cwikla et al, 2010) in group of 57 patients treated by 90Y-DOTATATE up to a cumulative activity of 15.2 GBq PFS and OS was about 17 and 22 months, respectively. During follow-up, transient decrease of PLT, WBC and haemoglobin values was observed. A increase of creatinine level and decrease of GFR values over observation period were found, but these were clinically insignificant symptoms of transient nephrotoxicity.
Conclusions PRRT and further treatment with long acting somatostatin analogues may extended the survival of disseminated patients with NETs. Long-term patients benefit (symptomatic relief and tumour mass reduction) after 90Y-DOTATATE therapy was observed.