Background:
The incidence of pancreatic Neuroendocrine Tumours (pNETs) has increased
considerably in the last few decades. The characteristic features of this tumour and the development of
new investigative and therapeutic methods had a great impact on its management.
Objective:
The aim of this review is to investigate the outcome of Peptide Receptor Radionuclide Therapy
(PRRT) in the treatment of pancreatic neuroendocrine tumours.
Methods:
A comprehensive literature search strategy was used based on two databases (SCOPUS, and
PubMed). We considered all studies published in English, evaluating the use of PRRT (177Luteciuim-
DOTA-conjugated peptides and 90Yetrium- DOTA- conjugated peptides) in the treatment of pancreatic
neuroendocrine tumours as a standalone entity or as a subgroup within the wider category of Gastroenteropancreatic
Neuroendocrine Tumours (GEP NETs).
Results:
PRRT was found to be an effective treatment modality as a monotherapy or in combination
with other therapies in the treatment of non-operable and metastatic pNETs where other options are
limited. Complete response was reported to be between 2-6% while partial response was achieved in up
to 60% of cases. Survival analysis was also impressive. Progression Free Survival (PFS) reached a mean
of 34 months and Overall Survival (OS) of 53 months. PRRT also proved to improve patients’ Quality
of Life (QoL). Acute and sub-acute side effects like nephrotoxicity and haematotoxicity are usually mild
and reversible.
Conclusion:
PRRT is well tolerated and effective treatment option for non-operable and/or metastatic
pNETs. Side effects are usually mild and reversible. Larger randomized controlled trails need to be done
to compare PRRT with other treatment modalities and to provide more detailed guidelines regarding
patient selections, the choice of PRRT, follow up and response assessment to maximum potential benefit.
Monitoring and Predicting Response to Peptide Receptor Radionuclide Therapy: A Quantitative SPECT-CT Based Analysis~!2009-12-10~!2010-02-04~!2010-04-21~!
