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Front Oncol. 2012 Feb 28;2:20. doi: 10.3389/fonc.2012.00020. eCollection 2012.

Neuroendocrine tumors: a focus on liver metastatic lesions.

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1
Athens University Medical Faculty, Nuclear Medicine Division, Radiology Department, Aretaieion University Hospital Athens, Greece.

Abstract

Transhepatic radionuclide infusion has been introduced as a new treatment approach for unresectable liver neuroendocrine metastatic lesions with the prerequisite of a positive In-111 Pentetreotide (Octreoscan). Patients with multiple liver neuroendocrine metastases can be locally treated after selective hepatic artery catheterization and infusion of radiolabeled somatostatin analogs, and in case of extra-hepatic secondary spread, after simple i.v. application. According to the world wide references, the average dose per session to each patient is 6.3 ± 0.3 GBq (∼160-180 mCi) of In-111-DTPA-Phe1-Pentetreotide, 10- to 12-fold in total, administered monthly or of 4.1 ± 0.2 GBq (∼105-116 mCi) of Y-90 DOTA TOC, threefold in total, or of 7.0 ± 0.4 GBq (∼178-200 mCi) of Lu-177 DOTA TATE, fourfold to sixfold in total (the choice of which being based on the tumor size, assessed by CT or MRI). Follow-up at monthly intervals has to be performed by means of ultrasonography (US). Treatment response has to be assessed according to the WHO criteria (RECIST or SWOG).

KEYWORDS:

In-111-DTPA-Phe1-pentetreotide; Y-90 DOTA TOC Lu-177 DOTA TATE; neuroendocrine tumors; radiopeptide therapy

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