Endocrine Abstracts (2006) 11 P900

Treatment of disseminated non-radioiodine - avid papillary thyroid cancer with 90Y-DOTA-TATE preparation

N Szalus, G Kaminski, K Obuchowski, J Pietrzykowski, Z Podgajny, M Zagrodzka & E Dziuk

Military Institute of Health Services, Warsaw, Poland.

Introduction: Lack of radioiodine uptake in Differentiated Thyroid Carcinoma is a huge diagnostic and therapeutic problem. This sign is associated with worse prognosis. DOTA-TATE preparation is a somatostatin analogue coupled with 90 Y which emites β (−) radiation. Its use in a treatment depends on excessive expression of somatostatin receptors (SSTR) in malignant tumours.

The aim of the study: To present a possibility of treatment of non iodine – avid dissemnated papillary thyroid cancer with 90Y-DOTA-TATE preparation. The local Ethical Committee approval has been obtained before.

Material and methods: 73 y. o. male with dissemnated non-radioiodine - avid papillary thyroid cancer has been treated by 90Y-DOTA-TATE. Presence of SSTR was confirmed with use of 99mTc-HYNIC-TATE (Tektrotyd) preparation earlier. Both of these radiopreparations are produced by POLATOM – Swierk/Poland. In March, April and July 2005 this patient was treated with the 90Y-DOTA-TATE three times (3.7 GBq per dose). Nephroprotection was obtained by 10 hours infusion of 1000 ml 10% amino acids preparation with max. speed 120 ml/h.

Results: There wern’t observed any serious adverse events after 90Y-DOTA-TATE treatment. Non significant, transient decrease of thrombocytes and lymphocytes was observed. Thyreoglobuline serum concentration increase was considered as a sign of cancer destruction. The reduction of neoplasm infiltrations in site of thyroid removal and in mediastinum and lungs in CT scans was observed two months after the third 90Y-DOTA-TATE injection. Histopathological estimation of excised the new superficial meta tumours of the neck region showed mainly necrosis and calcifications.

Conclusions: 90Y-DOTA-TATE preparation seems to be useful and promising in treatment of non – radioiodine – avid papillary thyroid cancer.

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