Abstract
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Objectives Neuroendocrine tumors (NET) have proven to be appropriate neoplasms for PRRT, as the majority of these slow-growing malignancies overexpress somatostatin receptors. As PRRT of P-NET is still considered as an investigational treatment, the aim of this study was to evaluate changes in quality of life of patients with P-NET following PRRT.
Methods Sixty-eight patients with P-NET (31 female, aged 61±13y) underwent PRRT: 12 with NET of grade 1, 40 of grade 2, 8 of grade 3 (grade non-available n=8). Prior to treatment, 39 patients showed ECOG 0, 26 patients ECOG 1, and 3 patients ECOG 2. Clinical assessment included evaluation of quality of life and symptom changes using standardized questionnaires (EORTC QLQ-C30) and was performed at baseline and every three months following each therapy cycle up to 12 months.
Results Up to four treatment cycles PRRT were performed in each patient with P-NET. The cumulative dose averaged to 27.1 GBq (±5.9). Compared to baseline status, quality of life was improved revealing increased global health status (3 months after 1st, 2nd, 3rd and 4th treatment cycle p=0.048, p=0.002, p<0.001, and p=0.008, respectively), emotional functioning (3 months after 1st-3rd cycle p=0.003, p=0.049, and p=0.001, respectively) and social functioning (3 months after 1st and 2nd p<0.001, after 3rd and 4th cycle p=0.015 and p=0.049, respectively). Furthermore, some symptoms were significantly alleviated compared with baseline: fatigue (after 1st-3rd cycle p=0.026, p=0.050, and p=0.008, respectively), nausea and vomiting (after 1st and 2nd cycle p=0.006 and p=0.001, respectively), pain (after 1st cycle p=0.022), dyspnea (after 3rd cycle p=0.025), appetite loss (after 1st-4th cycle p=0.010, p=0.001, p=0.009, and p=0.015, respectively), constipation (after 1st-3rd cycle p=0.050, p=0.003, and p=0.060, respectively). In addition, the ECOG status at baseline seemed to be relevant as observed changes in quality of life parameters were even more pronounced between ECOG groups.
Conclusions PRRT is an effective treatment of P-NET improving quality of life of patients in terms of increasing global health and functional status and alleviating some symptoms.