Neoadjuvant Treatment of Nonfunctioning Pancreatic Neuroendocrine Tumors with [177Lu-DOTA0,Tyr3]Octreotate

Journal of Nuclear Medicine

Eric P. Krenning¹  Jaap J. Teunissen¹  Dik J. Kwekkeboom¹  Wouter W. de Herder¹  Bert A. Bonsing¹  Ronald R. de Krijger¹  Tessa Brabander¹  Richard A. Feelders¹  Casper H. van Eijck¹  Esther I. van Vliet¹  Boen L. Kam¹  Elisabeth J. Nieveen van Dijkum¹ 

关键词: pancreatic neuroendocrine tumor;    PRRT;    [¹⁷⁷Lu-DOTA⁰;    Tyr³]octreotate;    neoadjuvant treatment;    surgery;   

DOI  :  10.2967/jnumed.115.158899

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Pancreatic neuroendocrine tumors (NETs) are rare neoplasms for which surgery has almost the only potential for cure. When surgery is not possible because of tumor size and vascular involvement, neoadjuvant treatment with [177Lu-DOTA0,Tyr3]octreotate (177Lu-octreotate) may be an option. Methods: We studied 29 Dutch patients with a pathology-proven nonfunctioning pancreatic NET treated with 177Lu-octreotate. All patients had a borderline or unresectable pancreatic tumor (group 1) or oligometastatic disease (defined as ≤3 liver metastases) (group 2). Progression-free survival (PFS) was analyzed using the Kaplan–Meier method and Cox proportional hazards modeling. Results: After the treatment with 177Lu-octreotate, successful surgery was performed in 9 of 29 patients (31%). Six patients had a Whipple procedure, 2 patients had a pylorus-preserving pancreaticoduodenectomy, and 1 patient had a distal pancreatectomy and splenectomy. The median PFS was 69 mo for patients with successful surgery and 49 mo for the other patients. For comparison, the median PFS in 90 other patients with a nonfunctioning pancreatic NET with more than 3 liver metastases or other metastases was 25 mo. Conclusion: Neoadjuvant treatment with 177Lu-octreotate is a valuable option for patients with initially unresectable pancreatic NETs.

【 授权许可】

Unknown