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J Nucl Med. 2008; 49 (Supplement 1):101P
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Oncology-Basic Science: Therapy, Metrics & Intervention

Clinical Radionuclide Therapy

Peptide receptor radionuclide therapy (PRRT) for progressive, somatostatin receptor positive pheochromocytoma/paraganglioma

Vikas Prasad1, C. Zachert1, C. Schuchardt1, R. Wortmann1 and Richard Baum1

1 Dept. of Nuclear Medicine/PET Center, Zentralklinik Bad Berka, Bad Berka, Germany

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Objectives: To determine the effectiveness of peptide receptor radionuclide therapy (PRRT) using Y-90-DOTA-TATE (Y-90) or Lu-177-DOTA-TATE (Lu-177) in patients with progressive metastasized pheochromocytoma (pheo) or paraganglioma (para).

Methods: Overall, 475 patients with metastasized neuroendocrine tumors have been treated with Y-90/Lu-177 in our center. 20 patients (54a; M:F-10:11) had pheo/para, non responsive to conventional therapies. All patients were selected for PRRT based upon high sstr expression on Ga-68-DOTA-NOC PET/CT. Patients were treated with 1-6 cycles of (2282-3553 MBq) Y-90 and/or (2700-7000) MBq of Lu-177 under renal protection with amino acid infusion. Three different groups were analysed: Y-90-DOTA-TATE alone (n=7), Lu-177-DOTA-TATE alone (n=5) and a (sequential) combination of Y-90- and Lu-177-DOTA-TATE (n=8).

Results: Best response (50%) was achieved by using Y-90- and Lu-177-DOTA-TATE in combination therapy. In the Y-90 group, 1/7 patients (14%) achieved a partial response, 2/7 patients (29%) had stable disease (SD), while 4/7 patients (57%) did not show a response. In the Lu-177 group, 1/5 patients (20%) achieved a minor response, 3/5 patients (60%) had SD; and 1/5 patients 20% did not respond. The median time interval between the first histopathological diagnosis and the first PRRT in patients with progressive disease even after PRRT (48 months) was much higher as compared to the patients responding to therapy.

Conclusions: PRRT has a therapeutic effect, even in advanced stages of pheochromocytoma or paraganglioma, non responsive to conventional therapies. Most impressive is the good clinical palliation (e.g. pain reduction in patients with widespread bone mets) with minor hematological/renal toxicity.





This Article
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Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Prasad, V.
Right arrow Articles by Baum, R.
PubMed
Right arrow Articles by Prasad, V.
Right arrow Articles by Baum, R.