Long-term follow-up and role of FDG PET in advanced pancreatic neuroendocrine patients treated with 177Lu-D OTATATE
- PMID: 27704193
- DOI: 10.1007/s00259-016-3533-z
Long-term follow-up and role of FDG PET in advanced pancreatic neuroendocrine patients treated with 177Lu-D OTATATE
Erratum in
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Erratum to: Long-term follow-up and role of FDG PET in advanced pancreatic neuroendocrine patients treated with 177Lu-D OTATATE.Eur J Nucl Med Mol Imaging. 2017 Feb;44(2):352. doi: 10.1007/s00259-016-3558-3. Eur J Nucl Med Mol Imaging. 2017. PMID: 27807661 No abstract available.
Abstract
Purpose: Lu-DOTATATE (Lu-PRRT) is a valid therapeutic option in differentiated pancreatic neuroendocrine tumors (P-NETs). FDG PET seems to be an important prognostic factor in P-NETs. We evaluated the efficacy of Lu-PRRT and the role of FDG PET in 60 patients with advanced P-NETs.
Methods: From March 2008 to June 2011, 60 consecutive patients with P-NETs were enrolled in the study. Follow-up lasted until March 2016. Eligible patients were treated with two different total cumulative activities (18.5 or 27.8 GBq in 5 cycles every 6-8 weeks), according to kidney and bone marrow parameters.
Results: Twenty-eight patients received a mean full activity (FA) of 25.9 GBq and 32 a mean reduced activity (RA) of 18.5 GBq. The disease control rate (DCR), defined as the sum of CR+PR+SD was 85.7 % in the FA group and 78.1 % in the RA group. Median progression-free survival (mPFS) was 53.4 months in the FA group and 21.7 months in the RA group (P = 0.353). Median overall survival (mOS) was not reached (nr) in FA patients and was 63.8 months in the RA group (P = 0.007). Fifty-five patients underwent an FDG PET scan before Lu-PRRT, 32 (58 %) showing an increased FDG uptake in tumor sites. mPFS was 21.1 months in FDG PET-positive patients and 68.7 months in the FDG PET-negative group (P < 0.0002), regardless of the total activity administered.
Conclusion: Both FA and RA are active in patients undergoing Lu-PRRT. However, an FA of 27.8 GBq of Lu-PRRT prolongs PFS and OS compared to an RA of 18.5 GBq. Our results indicate that FDG PET is an independent prognostic factor in this patient setting.
Keywords: 177Lu-DOTATATE; FDG PET; Long-term follow-up; P-NET; PRRT; Toxicity.
Comment in
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Predicting the outcome of peptide receptor radionuclide therapy in neuroendocrine tumors: the importance of dual-tracer imaging.Eur J Nucl Med Mol Imaging. 2017 Jun;44(6):1095-1096. doi: 10.1007/s00259-017-3667-7. Epub 2017 Mar 10. Eur J Nucl Med Mol Imaging. 2017. PMID: 28283701 No abstract available.
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Reply to: Predicting the outcome of peptide receptor radionuclide therapy in neuroendocrine tumors: the importance of dual-tracer imaging.Eur J Nucl Med Mol Imaging. 2017 Sep;44(10):1777-1778. doi: 10.1007/s00259-017-3682-8. Epub 2017 Mar 22. Eur J Nucl Med Mol Imaging. 2017. PMID: 28331955 No abstract available.
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