Neuroendocrine neoplasms (NENs) are a group of neoplasms arising from neuroendocrine cells. The worldwide incidence and prevalence of the NENs are estimated to be 6/100,000 and 35/100,000, respectively. Those numbers are increasing every decade, requiring higher and higher diagnosis and treatment costs. Radioligand therapy (RLT) using beta-emitting radioisotopes is an efficient and relatively safe method of treatment, typically used as a second-line treatment. RLT tolerability is higher than other available pharmacotherapies (chemotherapy or tyrosine kinase inhibitors). Recent studies show an increase in overall survival among patients treated with RLT. The present study aimed to learn the epidemiology of NENs in Poland and assess the effectiveness of RLT in a high-reference center. A prospective analysis of 167 patients treated with RLT in one of Poland’s highest-reference NEN centers was performed. The analysis covered 66 months of observation (1 December 2017–30 May 2023), during which 479 RLT single administrations of radioisotope were given. The standard procedure was to give four courses of [177Lu]Lu-DOTA-TATE alone, or tandem therapy—[177Lu]Lu-DOTA-TATE and [90Y]Y-DOTA-TATE. Grading analysis showed that most patients had non-functioning G2 NEN with a mean Ki-67 of 6.05% (SD ± 6.41). The most common primary tumor location was the pancreas. Over two-thirds of patients did undergo surgery due to primary tumors or distant metastases. The majority of patients were using lanreotide as a chronically injected somatostatin analog. Median progression-free survival (PFS) on somatostatin analogs was 21.0 (IQR = 29.0) months. Directly after the last course of RLT, disease stabilization was noted in 69.46% of patients, partial regression was noted in 20.36% of patients, complete regression was noted in 0.60% of patients, and progression was noted in 9.58% of patients. In long-term follow-up, the median observation time among patients who underwent four treatment cycles (n = 108) was 29.8 (IQR = 23.9) months. Stabilization of the disease was observed in 55.56% of the patients and progression was observed in 26.85% of the patients, while 17.59% of patients died. Median PFS was 29.3 (IQR 23.9), and the median OS was 34.0 months (IQR 16.0). The mean age of NEN diagnosis is the sixth decade of life. It takes almost three years from NEN diagnosis to the start of RLT. In long-term observation, RLT leads to disease stabilization in over half of the patients with progressive disease. No differences in PFS or OS depend on the radioisotope used for RLT. In Poland, organized coordination of NEN treatment in high-reference centers ensures the continuity of patient care.
神经内分泌肿瘤（NENs）是一类起源于神经内分泌细胞的肿瘤。据估计，全球NENs的发病率和患病率分别为6/10万和35/10万，且每十年呈上升趋势，导致诊疗成本持续攀升。采用β发射放射性同位素的放射性配体疗法（RLT）是一种高效且相对安全的治疗手段，通常作为二线治疗方案。相较于其他现有药物疗法（化疗或酪氨酸激酶抑制剂），RLT具有更好的耐受性。近期研究表明，接受RLT治疗的患者总生存期有所延长。本研究旨在探究波兰NENs的流行病学特征，并评估高参考价值医疗中心RLT的疗效。研究对波兰一家顶级NEN诊疗中心接受RLT治疗的167例患者进行了前瞻性分析。分析覆盖66个月的观察期（2017年12月1日至2023年5月30日），期间共实施479次单次放射性同位素给药。标准治疗方案为单独使用[¹⁷⁷Lu]Lu-DOTA-TATE进行四个疗程，或采用[¹⁷⁷Lu]Lu-DOTA-TATE与[⁹⁰Y]Y-DOTA-TATE的序贯疗法。分级分析显示，多数患者为非功能性G2级NEN，平均Ki-67指数为6.05%（标准差±6.41%）。胰腺是最常见的原发肿瘤部位。超过三分之二的患者曾因原发肿瘤或远处转移接受手术治疗。多数患者长期使用兰瑞肽作为生长抑素类似物注射治疗。生长抑素类似物治疗的中位无进展生存期（PFS）为21.0个月（四分位距=29.0）。末次RLT疗程结束后即刻评估显示：69.46%患者疾病稳定，20.36%部分缓解，0.60%完全缓解，9.58%出现进展。在长期随访中，完成四个治疗周期（n=108）的患者中位观察时间为29.8个月（四分位距=23.9），其中55.56%疾病稳定，26.85%出现进展，17.59%死亡。中位PFS为29.3个月（四分位距23.9），中位总生存期（OS）为34.0个月（四分位距16.0）。NEN确诊平均年龄为60岁左右，从确诊到开始RLT治疗的平均间隔近三年。长期观察表明，RLT能使半数以上进展期患者实现疾病稳定。不同放射性同位素RLT治疗的PFS或OS无显著差异。在波兰，高参考价值医疗中心建立的NEN治疗协同体系有效保障了患者诊疗的连续性。
肿瘤(癌症)患者之家