RESUMO
Restricted number of neuroendocrine tumors (NET) shows overexpression of somatostatin receptors. Therefore, long-acting somatostatin analogues are used in diagnosis and treatment of those tumors. Here we present our first case of NET, localized in pancreas treated with DOTA-D-Phe 1-Tyr 3-octreotide (DOTATATE), for receptor-mediated radioisotope therapy. DOTATATE is a newly developed somatostatin analogue labeled with beta-emitter yttrium 90 (90Y) and beta, gamma-emitter lutetium 177 (177Lu). A 34-year old woman was suffering from several years gastrointestinal symptoms. NET of the pancreas with multiple metastases into the liver was diagnosed based on histopatological, biochemical and radiological tests. First, she had chemiotherapy (leucovorin, 5-FU, cisplatin), however there was any positive effects of this therapy. Next, she received four single doses of 90Y DOTATATE at 4-6- week intervals, yielding a cumulative dose of 7.4 GBq/m2. During the 4th cycle the Lu-177 DOTATATE was additionally administered. As a renal protection i.v. infusion of amino acid solution were used during the treatment sessions. To date, patient has shown partial remission with reduction of tumor masses. We observed spectacular clinical, biochemical and radiological improvement. Radioisotope therapy could be a powerful and promising method of treatment at least in patients who had no other treatment option.