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Repeated cycles of peptide receptor radionuclide therapy (PRRT) - Results and side-effects of the radioisotope Y-DOTA TATE, Lu-DOTA TATE or Y/Lu-DOTA TATE therapy in patients with disseminated NET
Authors:Dorota PachJolanta Kunikowska,Leszek Kró  lickiMa?gorzata Trofimiuk,Agnieszka StefańskaMonika Tomaszuk,Bogus?aw G?owaRenata Miko?ajczak,Dariusz PawlakAgata Jabrocka-Hybel,Alicja B. Hubalewska-Dydejczyk
Affiliation:a Nuclear Medicine Unit, Endocrinology Department, Jagiellonian University, Krakow, Poland
b Nuclear Medicine Department, Warsaw Medical University, Poland
c Research and Development, IAE Radioisotope Centre POLATOM, Otwock-Swierk, Poland
Abstract:

Purpose

PRRT is a known tool in the management of patients with disseminated and inoperable NETs. The aim of study was to assess the effectiveness of the repeated cycles of PRRT in patients with disseminated and inoperable NETs.

Material and methods

Eighty nine patients were included in the PRRT. Among them 16 patients (18%) were qualified for a repeated PRRT cycle due to progression of the disease. In one of the patients qualified for the repeated cycle, PRRT was used as neoadjuvant therapy. The results and side-effects of the repeated cycles of PRRT were analyzed.

Results

Disease stabilization was observed in 10 patients 6 months after the repeated PRRT cycle and in 5 patients after 12 and 18 months. Ten of the patients who had received repeated PRRT cycles died. In the case of neoadjuvant therapy, further reduction of the tumor size was observed, enabling qualification for surgery. Clinically significant reduction in the mean values of morphological parameters was not observed. Only after 12 and 18 months the mean values of creatinine levels were higher than the normal range (only in 2 patients).

Conclusions

The repeated cycles of PRRT did not cause a clinically significant increase of the toxicity of PRRT. The changes in kidney and blood morphology parameters were transient. The repeated cycles of PRRT enabled stabilization of the disease.
Keywords:Neuroendocrine tumors   Peptide receptor radionuclide therapy (PRRT)   Repeated cycles of PRRT   Renal toxicity   Bone marrow toxicity
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