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Journal of Nuclear Medicine

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Research ArticleTheranostics

Risk of Bowel Obstruction in Patients with Mesenteric or Peritoneal Disease Receiving Peptide Receptor Radionuclide Therapy

Jonathan R. Strosberg, Taymeyah Al-Toubah, Eleonora Pellè, Johnna Smith, Mintallah Haider, Tai Hutchinson, Jason B. Fleming and Ghassan El-Haddad
Journal of Nuclear Medicine January 2021, 62 (1) 69-72; DOI: https://doi.org/10.2967/jnumed.120.242875
Jonathan R. Strosberg
1Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
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Taymeyah Al-Toubah
1Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
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Eleonora Pellè
1Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
2Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy; and
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Johnna Smith
3Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida
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Mintallah Haider
1Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
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Tai Hutchinson
1Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
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Jason B. Fleming
1Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida
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Ghassan El-Haddad
3Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida
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Abstract

Although radiation-induced mesenteritis or peritonitis can potentially exacerbate the risk of bowel obstruction, there are no data in the literature on the incidence of intestinal obstruction related to peptide receptor radionuclide therapy. Methods: The records of all patients treated with 177Lu-DOTATATE at Moffitt Cancer Center between April 2018 and October 2019 were evaluated. The number of patients who developed bowel obstruction within 3 mo of a 177Lu-DOTATATE treatment was divided by the total number of patients with preexisting peritoneal or mesenteric disease. Management strategies and outcomes were evaluated. Results: Of a total of 159 patients treated, 81 had baseline mesenteric or peritoneal disease, among whom 5 (6%) experienced at least 1 episode of bowel obstruction within 3 mo of treatment. Two of the patients underwent surgical exploration during obstruction describing a “frozen abdomen.” All 5 responded at least temporarily to high-dose corticosteroid treatment and regained bowel function, but 2 patients eventually succumbed to progressive peritoneal disease. Conclusion: Peptide receptor radionuclide therapy can lead to bowel obstruction in patients with mesenteric or peritoneal disease, likely by inducing inflammation. Corticosteroids can potentially play a role in treatment and prophylaxis.

  • 177Lu-DOTATATE
  • peptide receptor radionuclide therapy
  • bowel obstruction
  • intestinal obstruction

Footnotes

  • Published online May 22, 2020.

  • © 2021 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 62 (1)
Journal of Nuclear Medicine
Vol. 62, Issue 1
January 1, 2021
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Risk of Bowel Obstruction in Patients with Mesenteric or Peritoneal Disease Receiving Peptide Receptor Radionuclide Therapy
Jonathan R. Strosberg, Taymeyah Al-Toubah, Eleonora Pellè, Johnna Smith, Mintallah Haider, Tai Hutchinson, Jason B. Fleming, Ghassan El-Haddad
Journal of Nuclear Medicine Jan 2021, 62 (1) 69-72; DOI: 10.2967/jnumed.120.242875

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Risk of Bowel Obstruction in Patients with Mesenteric or Peritoneal Disease Receiving Peptide Receptor Radionuclide Therapy
Jonathan R. Strosberg, Taymeyah Al-Toubah, Eleonora Pellè, Johnna Smith, Mintallah Haider, Tai Hutchinson, Jason B. Fleming, Ghassan El-Haddad
Journal of Nuclear Medicine Jan 2021, 62 (1) 69-72; DOI: 10.2967/jnumed.120.242875
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Keywords

  • 177Lu-DOTATATE
  • peptide receptor radionuclide therapy
  • bowel obstruction
  • intestinal obstruction
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