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Endocrine Abstracts (2007) 14 P131

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1Nuclear Medicine Department, Medical Academy, Warsaw, Poland; 2Department of Endocrinology, Medical College at Jagiellonian University, Cracow, Poland; 3Radioisotope Centre POLATOM, Otwock-Swierk, Poland.


In the 1980 s the discovery of expression of somatostatin receptors on NET cells made the use of somatostatin analogues in diagnosis and therapy possible.

The aim: Of the study was to assess response of targeted radio-nuclide therapy with radio-labelled somatostatin analogue 90Y-[DOTA0,D-Phe1,Tyr3]-octreotate (DOTATATE) in treatment of disseminated NETs.

Material and methods: 12 patients (aged 56.7+/−11.2): carcinoid-5 pts, insulinoma-1pt, gastrinoma-2 pts, pancreatic NET-2 pts, ca neauroendocrinale without primary tumor-1, stomach NET-1 pt) were enrolled in the study. Before the therapy, blood tests for hematology, kidney and liver function and CgA were performed. All patients underwent CT scans and 99mTc-HYNIC/EDDA-octreotate SRS. Treatment with 90Y-DOTATATE) was repeated every 4–6 weeks up to the total of 200 mCi/m2. Amino acids infusion was used for kidney protection.

Results: One year observation: regression of disease (PR -decrease of size and number of metastases, ↓CgA level, good clinical response) was observed in 6 pts, stable disease (SD-stable size and number of metastases, ↓CgA) in 3 pts. 3 patients died. No nephrotoxicity was observed. WBC and PLT levels were stable during therapy in 3 pts (without chemotherapy). In 1 pt with previous chemotherapy (last course a month before radiotherapy), PLT level decreased (220×103/mm3 ® 47×103/mm3after the first course); the patient died 2 months after the beginning of the therapy. In 8 pts leucopoenia was observed (< 4×103/mm3) but serious neutropenia (<2×103/mm3) was found in 3 pts with previous chemotherapy. Thrombocytopenia (PLT<100×103/mm3) was observed in 2 patients with previous chemotherapy.

Two-year observation: prolonged PR – 4 pts; SD – 3 pts, progression of disease in 2 pts: with gastrinoma and stomach NET without hormonal activity (4 and 9 months after radiotherapy). Blood tests stable.

Conclusion: PR and SD were observed in 9/12 patients with disseminated NET. Severe haematologic toxicity was mainly observed in patients after prior chemotherapy –the question of optimising the time between chemotherapy and radiotherapy is still open.

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