Peptide Receptor Radionuclide Therapy (PRRT) with 177Lu-DOTATATE in Individuals with Neck or Mediastinal Paraganglioma (PGL)

被引:61
作者
Zovato, S. [1 ]
Kumanova, A. [1 ]
Dematte, S. [2 ]
Sansovini, M. [3 ]
Bodei, L. [4 ]
Di Sarra, D. [2 ]
Casagranda, E. [2 ]
Severi, S. [3 ]
Ambrosetti, A. [3 ]
Schiavi, F. [1 ]
Opocher, G. [1 ]
Paganelli, G. [4 ]
机构
[1] Veneto Oncol Inst IOV, Familial Canc Clin, Padua, Italy
[2] Santa Chiara Hosp, Trento, Italy
[3] Ist Sci Romagnolo Studio & Cura Tumori, Radiometab Unit, Meldola, FC, Italy
[4] European Inst Oncol IEO, Div Nucl Med, Milan, Italy
关键词
Lu-177-DOTATATE; paraganglioma; hereditary; SOLID TUMORS; PHEOCHROMOCYTOMAS; MUTATIONS; SCINTIGRAPHY; MANAGEMENT; DIAGNOSIS; GENE; HEAD;
D O I
10.1055/s-0032-1311637
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Paragangliomas (PGLs) are neuroendocrine tumors that arise embryologically from the neural crest. Sympathetic PGLs can be located in the thoracic-abdominal region while parasympathetic PGLs are mainly situated in the head and neck region. Most PGLs are sporadic, but in 30% of cases they are hereditary (associated with mutations of SDHB, SDHC, SDHD, SDHAF2, SDHA, TMEM, MAX, and VHL); they can be classified into 4 different paraganglioma syndromes: PGL1, PGL2, PGL3, and PGL4. Surgery is the treatment of choice for both sympathetic and parasympathetic PGLs. Other types of treatment include medical agents (such as gemcitabine, cisplatin, or sunitinib) and radiotherapy (external-beam radiotherapy or stereotactic surgery). Surgery and radiotherapy, however, can cause important side effects such as vascular complications and peripheral nerve damage (hypoglossal, recurrent laryngeal, glossopharyngeal, and vagus). Another possible treatment option is the use of peptide receptor radionuclide therapy (PRRT), including PRRT with Lu-177-DOTATATE. We studied 4 patients with hereditary nonmetastatic paraganglioma syndrome type 1 (PGL1), with progressive disease, in whom surgical excision was not possible. They were treated with Lu-177-DOTATATE (3-5 cycles) and all had a partial response (PR) or a stable disease (SD) to the treatment. In conclusion, a good alternative treatment when surgical or radiation therapy are contraindicated could be radiometabolic therapy with Lu-177-DOTATATE.
引用
收藏
页码:411 / 414
页数:4
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