Quality of Life in 265 Patients with Gastroenteropancreatic or Bronchial Neuroendocrine Tumors Treated with [177Lu-DOTA0,Tyr3]Octreotate

Journal of Nuclear Medicine

Martijn van Essen¹  Eric P. Krenning¹  Jaap J. Teunissen¹  Dik J. Kwekkeboom¹  Saima Khan¹  Boen L. Kam¹ 

[1] Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

关键词: gastroenteropancreatic neuroendocrine tumor;    bronchial neuroendocrine tumor;    quality of life;    health-related quality of life;    peptide receptor radionuclide therapy;    [¹⁷⁷Lu-DOTA⁰;    Tyr³]octreotate;   

DOI  :  10.2967/jnumed.111.087932

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Quality of life (QOL) is an important outcome in cancer therapy. In this study, we investigated the QOL and symptoms after [177Lu-DOTA0,Tyr3]octreotate (177Lu-octreotate) therapy in patients with inoperable or metastasized gastroenteropancreatic or bronchial neuroendocrine tumors (NETs). Methods: Two hundred sixty-five Dutch patients completed the QOL questionnaire of the European Organization for the Research and Treatment of Cancer after being treated for NETs. ANOVA was used for statistical analyses, with a P value of 0.05 or less being considered significant. Differences of at least 10 points in global health status (GHS)/QOL scores, symptom scores, and Karnofsky performance scores (KPS) before and after therapy were regarded as indicating an improvement. Results: Regardless of the treatment outcome, GHS/QOL, insomnia, appetite loss, and diarrhea improved significantly in the total group. These improvements were also seen in patients with bone metastases or a decrease of 50% or more in chromogranin A. Improvement in the scores by at least 10 points was also analyzed in a subgroup of patients with decreased GHS/QOL or symptoms at the start of therapy: in 36% of these patients, GHS/QOL improved after therapy; in 49%, fatigue; in 70%, nausea plus vomiting; in 53%, pain; in 44%, dyspnea; in 59%, insomnia; in 63%, appetite loss; in 60%, constipation; and in 67%, diarrhea. Additionally, we did not see a statistically significant deterioration in patients who had GHS/QOL 100, KPS 100, or no symptoms at the start. In patients with initial stable disease or remission after treatment, GHS/QOL and KPS decreased significantly when regrowth of the tumors occurred. Conclusion: GHS/QOL, KPS, and symptoms improved significantly after 177Lu-octreotate therapy, and there was no significant decrease in QOL in patients who had no symptoms before therapy. In patients who had suboptimal scores for GHS/QOL or symptoms before therapy, a clinically significant improvement was demonstrated. Our results indicate that 177Lu-octreotate therapy not only reduces tumors and prolongs overall survival but also improves the patients’ self-assessed QOL.

【 授权许可】

Unknown