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Is there a role for peptide receptor radionuclide therapy in medullary thyroid cancer?
Journal article   Peer reviewed

Is there a role for peptide receptor radionuclide therapy in medullary thyroid cancer?

Fernanda Vaisman, Paulo Henrique Rosado De Castro, Flavia Paiva Proença Lobo Lopes, Daniel Barretto Kendler, Cencita H.N. Pessoa, Daniel Alves Bulzico, Douglas De Carvalho Leal, Bruno Vilhena, Mario Vaisman, Michel Carneiro, …
Clinical nuclear medicine, Vol.40(2), pp.123-127
02/2015
DOI: 10.1097/RLU.0000000000000628
PMID: 25546220

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Abstract

Background Medullary thyroid cancer (MTC) is a rare but potentially life-threatening disease with limited therapeutic options. As a neuroendocrine tumor, MTC expresses somatostatin receptors, and therefore, somatostatin-labeled radiopharmaceuticals could be used to treat patients with MTC. Objective The aims of this study were to evaluate tumor shrinkage after 177Lu-DOTATATE treatment, to analyze the impact on quality of life as accessed by the SF-36 questionnaire, and to demonstrate a possible prognostic role for 111In-DTPA-octreotide uptake in patients with MTC. Patients and Methods Patients with progressive MTC underwent evaluation using 111In-DTPA-octreotide. Patients who demonstrated 111In-DTPA-octreotide uptake were treated with 4 cycles of 200 mCi of 177Lu-DOTATATE and were evaluated using CT scans over 8 to 12 months of treatment. Results Of the 16 patients initially enrolled, 9 (56.25%) had lesions that were observed in the 111In-DTPA-octreotide scans and were eligible for therapy with 177Lu-DOTATATE. Three patients had a partial response, 3 patients were classified as having stable disease and, 1 patient had a progressive disease. All responders indicated improvement in quality of life 6 to 12 months after therapy. Conclusions Treatment with 177Lu-DOTATATE seems to be an alternative therapy for somatostatin receptor–positive tumors, with very mild adverse effects and quality-of-life improvement, at least during a short-term period. Further studies are needed to determine long-term benefits and to identify which patients are more likely to respond to this modality of therapy.
Quality of Life In-DTPA-octreotide Lu-DOTATATE medullary thyroid cancer peptide receptor radionuclide therapy

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