Background: Neuroendocrine neoplasms (NENs) are neoplastic tumors developing in every part of the body, mainly in the gastrointestinal tract and pancreas. Their treatment involves the surgical removal of the tumor and its metastasis, long-acting somatostatin analogs, chemotherapy, targeted therapy, and radioligand therapy (RLT). Materials and Methods: A total of 127 patients with progressive neuroendocrine neoplasms underwent RLT—4 courses, administered every 10 weeks—with the use of 7.4 GBq [177Lu]Lu-DOTA-TATE or tandem therapy with 1.85 GBq [177Lu]Lu-DOTA-TATE and 1.85 GBq [90Y]Y-DOTA-TATE. Assessment of short- and long-term complications, as well as the calculation of progression-free survival (PFS) and overall survival (OS) were performed. Results: RLT caused a statistically but not clinically significant decrease in blood morphology parameters during both short- and long-term observations. Glomerular filtration rate (GFR) significantly decreased only in a long-term observation after RLT; however, it was clinically acceptable. Computed predictions of progression-free survival (PFS) and overall survival (OS) indicated that five years post-RLT, there is a 74% chance of patients surviving, with only a 58.5% likelihood of disease progression. Conclusions: Computed predictions of PFS and OS confirmed treatment efficiency and good patient survival. RLT should be considered a safe and reliable line of treatment for patients with progressive NENs as it causes only a low number of low-grade adverse events.
背景：神经内分泌肿瘤（NENs）是一种可发生于全身各部位的肿瘤性病变，主要见于胃肠道和胰腺。其治疗手段包括手术切除原发灶及转移灶、长效生长抑素类似物治疗、化疗、靶向治疗以及放射性配体治疗（RLT）。材料与方法：本研究共纳入127例进展性神经内分泌肿瘤患者，接受每10周一次、共计4个周期的RLT治疗，治疗方案为单用7.4 GBq [¹⁷⁷Lu]Lu-DOTA-TATE或采用1.85 GBq [¹⁷⁷Lu]Lu-DOTA-TATE联合1.85 GBq [⁹⁰Y]Y-DOTA-TATE的序贯疗法。研究对短期及长期并发症进行评估，并计算无进展生存期（PFS）与总生存期（OS）。结果：在短期与长期观察中，RLT均引起血液形态学参数出现统计学显著但临床意义有限的下降。肾小球滤过率（GFR）仅在RLT后的长期观察中出现显著降低，但其降低幅度在临床可接受范围内。基于计算模型预测的无进展生存期（PFS）与总生存期（OS）显示，RLT治疗后五年患者生存概率为74%，而疾病进展可能性仅为58.5%。结论：通过计算模型预测的PFS与OS结果证实了该治疗方法的有效性及良好的患者生存获益。对于进展性神经内分泌肿瘤患者，RLT应被视为安全可靠的治疗选择，因其仅引发少量低级别不良事件。
肿瘤(癌症)患者之家