RESUMEN
La terapia con péptidos análogos de la somatostatina marcados con radionúclidos es un nuevo tratamiento prometedor para tratar tumores neuroendocrinos. El objetivo del presente estudio preliminar es presentar nuestra experiencia en la terapia con 177Lu-DOTATATE y evaluar la tolerabilidad y la eficacia a corto plazo en pacientes con tumores que expresan receptores para la somatostatina. Se han tratado 7 pacientes con tumores neuroendocrinos metastásicos, cada uno con 4 dosis de 177Lu-DOTATATE y se ha evaluado su respuesta al tratamiento en forma de respuesta bioquímica (marcadores tumorales y analítica), según métodos de imagen (gammagrafía de receptores de somatostatina, tomografía computarizada y resonancia magnética) y respuesta funcional y de calidad de vida (mediante la Escala de actividad de Karnofsky). Se ha evaluado también la toxicidad del tratamiento. Los resultados obtenidos han sido los siguientes: respuesta bioquímica: el 60% de los pacientes mostraron una normalización de sus niveles de marcadores tumorales, mientras que en el 40% disminuyeron de manera significativa; respuesta en técnicas de imagen: el 85,7% presentaron una respuesta parcial, mientras que el 14,3% mostraron enfermedad estable; mejoría de la calidad de vida: el 100% de los pacientes mostraron una mejoría significativa en la calidad de vida con un incremento de la Escala de actividad de Karnofsky, y en cuanto a la toxicidad: ningún paciente presentó toxicidad aguda o crónica, y el 42,8% de los pacientes presentaron toxicidad subaguda hematológica transitoria. A pesar de tratarse de un estudio preliminar podemos afirmar que el tratamiento con 177Lu-DOTATATE es un tratamiento seguro, con pocos efectos adversos y que consigue una respuesta objetiva en la mayoría de los pacientes (AU)
Therapy with radiolabelled somatostatin analogue peptides is a promising new therapy to treat neuroendocrine tumours. The aim of this preliminary study is to present our experience with 177Lu-DOTATATE therapy, and evaluate tolerability and short-term efficacy in patients with tumours expressing somatostatin receptors. A total of 7 patients with metastatic neuroendocrine tumours were treated, each with 4 doses of 177Lu-DOTATATE. The treatment response was evaluated in the form of biochemical response (tumour markers), imaging methods (somatostatin receptor scintigraphy, computed tomography, and magnetic resonance), and functional and quality of life responses using the Karnofsky performance status scale. Treatment toxicity was also evaluated. The results obtained were as follows: Biochemical response: 60% of patients showed tumour marker levels returning to normal, while they decreased significantly in the remaining 40%. Imaging response: 85.7% had a partial response, while 14.3% showed stable disease. All (100%) patients showed a significant improvement in quality of life, with increased Karnofsky scale scores. No patient had acute or chronic toxicity, and subacute transient haematological toxicity was observed in 42.8% of patients. Despite being a preliminary study, it was found that treatment with 177Lu-DOTATATE is a safe treatment with few side effects, and an objective response was achieved in most patients (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Tumores Neuroendocrinos/radioterapia , Tumores Neuroendocrinos , Somatostatina/análogos & derivados , Radioisótopos/uso terapéutico , Calidad de Vida , Radiofármacos/análisis , Fluorodesoxiglucosa F18/administración & dosificación , Cintigrafía/métodos , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética/métodos , Medicina Nuclear/métodos , Estado de Ejecución de Karnofsky/normas , Tomografía de Emisión de Positrones/métodosRESUMEN
Therapy with radiolabelled somatostatin analogue peptides is a promising new therapy to treat neuroendocrine tumours. The aim of this preliminary study is to present our experience with 177Lu-DOTATATE therapy, and evaluate tolerability and short-term efficacy in patients with tumours expressing somatostatin receptors. A total of 7 patients with metastatic neuroendocrine tumours were treated, each with 4 doses of 177Lu-DOTATATE. The treatment response was evaluated in the form of biochemical response (tumour markers), imaging methods (somatostatin receptor scintigraphy, computed tomography, and magnetic resonance), and functional and quality of life responses using the Karnofsky performance status scale. Treatment toxicity was also evaluated. The results obtained were as follows: Biochemical response: 60% of patients showed tumour marker levels returning to normal, while they decreased significantly in the remaining 40%. Imaging response: 85.7% had a partial response, while 14.3% showed stable disease. All (100%) patients showed a significant improvement in quality of life, with increased Karnofsky scale scores. No patient had acute or chronic toxicity, and subacute transient haematological toxicity was observed in 42.8% of patients. Despite being a preliminary study, it was found that treatment with 177Lu-DOTATATE is a safe treatment with few side effects, and an objective response was achieved in most patients.