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European Radiology

, Volume 28, Issue 12, pp 5250–5257 | Cite as

CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold?

  • Yanji Luo
  • Jie Chen
  • Bingqi Shen
  • Meng Wang
  • Huasong Cai
  • Ling Xu
  • Luohai Chen
  • Minhu Chen
  • Zi-Ping LiEmail author
  • Shi-Ting FengEmail author
Gastrointestinal
  • 227 Downloads

Abstract

Objective

To identify a reliable early indicator of deriving progression-free survival (PFS) benefit in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with octreotide long-acting repeatable (LAR).

Methods

We investigated the images of 50 patients with well-differentiated advanced GEP-NETs treated with LAR octreotide and underwent baseline and follow-up thoracic, abdominal, and pelvic computed tomography. Receiver-operating characteristic (ROC) analysis and the Kaplan-Meier method were used to identify the optimal threshold to distinguish between those with and without significant improvement of PFS.

Results

The optimal threshold for determining a response to octreotide LAR was -10% ΔSLD, with a sensitivity and specificity of 85.7% and 80%, respectively. At this threshold, 19 patients were responders and 31 were non-responders; the median PFS was 20.2 and 7.6 months in responders and non-responders (hazard ratio, 2.66; 95% confidence interval, 1.32–5.36).

Conclusion

A 10% shrinkage in tumor size is an optimal early predictor of response to octreotide LAR in advanced GEP-NETs.

Key points

Octreotide LAR can significantly prolong PFS among patients with well-differentiated advanced GEP-NETs.

No optimal tumor size-based response criteria are reported in GEP-NETs with octreotide.

Ten percent tumor shrinkage is a reliable indicator of the response to octreotide for advanced GEP-NETs.

Keywords

Neuroendocrine tumors Octreotide Progression-free survival Response Evaluation Criteria in Solid Tumors Tomography, spiral computed 

Abbreviations

CT

Computed tomography

GEP-NETs

Gastroenteropancreatic neuroendocrine tumors

Octreotide LAR

Octreotide long-acting repeatable

PD

Progressive disease

PFS

Progression-free survival

PR

Partial response

RECIST

Response Evaluation Criteria in Solid Tumors

ROC curve

Receiver-operating characteristic curve

SD

Stable disease

SLD

Sum of the longest diameters

SSAs

Somatostatin analogs

TACE

Transhepatic arterial chemotherapy and embolization

WDGEP-NETs

Well-differentiated advanced gastroenteropancreatic neuroendocrine tumors

ΔSLD

Change in the sum of the longest tumor diameters

Notes

Funding

National Natural Science Foundation of China (81771908,81571750, 81770654), National Key Research and Development Program of China (2017YFC0113402), Guangzhou Science and Technology Foundation (201804010078). Natural Science Foundation of Guangdong Province (2015A030313043).

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Shi-Ting Feng.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Ms. Fangjing Zhou (expert in statistics, Sun Yat-Sen University) kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2018_5512_MOESM1_ESM.pdf (105 kb)
Figure 5 (PDF 104 kb)

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Yanji Luo
    • 1
  • Jie Chen
    • 2
  • Bingqi Shen
    • 1
  • Meng Wang
    • 1
  • Huasong Cai
    • 1
  • Ling Xu
    • 3
  • Luohai Chen
    • 2
  • Minhu Chen
    • 2
  • Zi-Ping Li
    • 1
    Email author
  • Shi-Ting Feng
    • 1
    Email author
  1. 1.Department of Radiology, The First Affiliated HospitalSun Yat-Sen UniversityGuangzhouChina
  2. 2.Department of Gastroenterology, The First Affiliated HospitalSun Yat-Sen UniversityGuangzhouChina
  3. 3.Faculty of Medicine and DentistryUniversity of Western AustraliaPerthAustralia

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