Response of Recurrent High-Grade Glioma to Treatment with 90Y-DOTATOC

The treatment of patients with high-grade malignant glioma still represents an unsolved clinical problem. We report the treatment of 3 patients who had World Health Organization grade IV recurrent glioblastoma: a 23-y-old woman and 2 men aged 61 and 62 y. Methods: All 3 patients were treated with the somatostatin receptor radiopharmaceutical Y-90-labeled [1,4,7,10-tetraazacyclododecane-N, N', N '', N'''-tetraacetic acid(0)-D-Phe(1),Tyr(3)]octreotide (DOTATOC). A cumulated dose of 1.7-2.2 GBq given in 3 or 4 cycles was locally injected into a previously implanted catheter system. Results: Treatment was successful in all 3 patients, with only minor side effects reported. After treatment, MRI and PET showed complete remission in one patient and partial remission in the other patients. These findings correlated well with clinical improvement and improved quality of life. Conclusion: Receptor-mediated radionuclide therapy by locally injected Y-90-DOTATOC is feasible and well tolerated. This approach represents an attractive strategy for the treatment of locally recurring or progressing glioblastoma.