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Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

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Abstract

90Y radioembolization and peptide-receptor radionuclide therapy (PRRT) with177Lu-DOTATATE are both effective treatments for patients with inoperable neuroendocrine metastatic tumors (NET). We report the case of a 72-year-old man with severe functional syndrome due to a metastatic NET. 68Ga-DOTATOC positron-emission tomography (PET) revealed high somatostatin receptor expression in a gross liver metastasis, in one abdominal lymph node and in several skeletal lesions. The patient underwent liver radioembolization with 90Y-resin microspheres followed by four cycles of PRRT with177Lu-DOTATATE. After 3 months, a complete remission of the functional syndrome was observed. 68Ga-DOTATOC PET demonstrated a complete response for skeletal and lymph nodal lesions with a residual bulky mass in the liver. Therefore a further 90Y radioembolization was performed as consolidation treatment for the hepatic lesion. Six months after these combined treatments, 68Ga-DOTATOC PET demonstrated complete metabolic response in liver and stable extrahepatic lesions. No significant long-term adverse reactions were registered. To our knowledge, the sequential use of 90Y radiembolization before and after PRRT in a liver-dominant advanced NET has not been reported in the literature and this case suggests that these combined treatments can be safe and effective.

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Acknowledgements

All human and animal studies were approved by the appropriate ethics committee and were therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of Interest

Luca Filippi, Alida Ciorra, Barbara Sardella, Orazio Schillaci, and Oreste Bagni declare no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, PET Unit, Santa Maria Goretti Hospital, Via Canova 3, 04100, Latina, Italy

    Luca Filippi & Oreste Bagni

  2. Department of Oncology, Santa Maria Goretti Hospital, via Canova 3, 04100, Latina, Italy

    Alida Ciorra

  3. Department of Pathology, Santa Maria Goretti Hospital, via Canova 3, 04100, Latina, Italy

    Barbara Sardella

  4. Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy

    Orazio Schillaci

Authors
  1. Luca Filippi
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  2. Alida Ciorra
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  3. Barbara Sardella
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  4. Orazio Schillaci
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  5. Oreste Bagni
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Correspondence to Luca Filippi.

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Filippi, L., Ciorra, A., Sardella, B. et al. Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report. Nucl Med Mol Imaging 48, 321–325 (2014). https://doi.org/10.1007/s13139-014-0292-2

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  • DOI: https://doi.org/10.1007/s13139-014-0292-2

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