RT Journal Article
SR Electronic
T1 Long-Term Follow-Up of Renal Function After Peptide Receptor Radiation Therapy with <sup>90</sup>Y-DOTA<sup>0</sup>,Tyr<sup>3</sup>-Octreotide and <sup>177</sup>Lu-DOTA<sup>0</sup>, Tyr<sup>3</sup>-Octreotate
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 83S
OP 91S
VO 46
IS 1 suppl
A1 Roelf Valkema
A1 Stanislas A. Pauwels
A1 Larry K. Kvols
A1 Dik J. Kwekkeboom
A1 Francois Jamar
A1 Marion de Jong
A1 Raffaella Barone
A1 Stephan Walrand
A1 Peter P.M. Kooij
A1 Willem H. Bakker
A1 Janet Lasher
A1 Eric P. Krenning
YR 2005
UL http://jnm.snmjournals.org/content/46/1_suppl/83S.abstract
AB The kidneys are critical organs in peptide receptor radiation therapy (PRRT). Renal function loss may become apparent many years after PRRT. We analyzed the time course of decline in creatinine clearance (CLR) in patients during a follow-up of at least 18 mo after the start of PRRT with 90Y-1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid (DOTA),Tyr3-octreotide (90Y-DOTATOC) or 177Lu-DOTA0,Tyr3-octreotate (177Lu-DOTATATE). Methods: Twenty-eight patients with metastasized neuroendocrine tumors received 1–5 cycles of 90Y-DOTATOC, leading to renal radiation doses of 5.9–26.9 Gy per cycle and a total of 18.3–38.7 Gy. Median follow-up was 2.9 y (range, 1.5–5.4 y), with a median of 16 measurements (range, 5–53) per patient. Thirty-seven patients with metastasized neuroendocrine tumors received 3–7 cycles of 177Lu-DOTATATE, leading to renal radiation doses of 1.8–7.8 Gy per cycle and a total of 7.3–26.7 Gy. Median follow-up was 2.4 y (range, 1.7–4.0 y), with a median of 10 (range, 6–27) measurements per patient. All renal dose estimates were calculated with the MIRDOSE3 model. All patients were infused with renoprotective amino acids during the administration of the radioactive peptides. The time trend of CLR was determined by fitting a monoexponential function through the data of individual patients, yielding the decline in CLR in terms of percentage change per year. Results: The median decline in CLR was 7.3% per y in patients treated with 90Y-DOTATOC and 3.8% per y in patients treated with 177Lu-DOTATATE (P = 0.06). The time trend of decline in CLR was sustained during the follow-up period. Eleven patients had a &gt;15% per y decline in CLR. Cumulative renal radiation dose, per-cycle renal radiation dose, age, hypertension, and diabetes are probable contributing factors to the rate of decline in CLR after PRRT. Conclusion: This study showed that the time course of CLR after PRRT was compatible with the pattern of sustained CLR loss in progressive chronic kidney disease.