^90Y—DOTATATE治疗进展期神经内分泌肿瘤的临床价值  

Treatment of advanced neuroendocrine tumors with ^90Y-DOTATATE

作　　者：陈永辉[1] 李方[1] 贾兵[2] 景红丽[1] 陈黎波[1] 陈方[1] 王凡[2] 杜延荣[1] 马艳茹[1] 欧阳萌[1] 林岩松[1] 康增寿[1] 

机构地区：[1]中国医学科学院、北京协和医学院北京协和医院核医学科,100730 [2]北京大学医学同位素研究中心

出　　处：《中华核医学杂志》2010年第1期1-4,共4页Chinese Journal of Nuclear Medicine

基　　金：首都医学发展科研基金（2002-2011）

摘　　要：目的评价^90Y-生长抑素类似物1，4，7，10-四氮杂十二环-1，4，7，10-四乙酸-octreotate（^90Y-（DOTA）^0，Tyr^3]oetreotate，即^90Y—DOTATATE）联合使用。肾保护剂赖氨酸治疗进展期神经内分泌肿瘤的疗效以及不良反应。方法25例进展期神经内分泌肿瘤患者，经生长抑素受体（SSTR）显像（SRS）诊断为SSTR阳性肿瘤。^90Y—DOTATATE在30min内静脉滴注完毕，用药前后输注赖氨酸。每人完成1～5次治疗，间隔时间为6～9周。每次单程治疗后根据美国国立癌症研究院分级标准（NCIGC）评价不良反应。完成末次治疗后8周依据WHO标准评价疗效。结果部分缓解1例，占4％（1／25）；轻微缓解3例，占12％（3／25）；病情稳定16例，占64％（16／25）；病情进展5例，占20％（5／25）。2例出现不同程度的肾功能损害，3例出现白细胞下降，出现恶心及呕吐症状各3例。结论以赖氨酸作为肾保护剂，^90Y—DOTATATE治疗转移和不能手术的神经内分泌肿瘤是一种有效的新疗法；但应该进一步采取措施减轻肾毒性。Objective To evaluate the efficacy and side effects of [^90Y -1, 4, 7, 10-tetraazacyclododecane-N, N′, N″, N″-tetraacetie acid （DOTA） ^0, Tyr^3 ] octreotate （ ^90 Y-DOTATATE ） combined with lysine as a renal protective agent. Methods Twenty-five patients with advanced neuroendocrine tumors were confirmed as somatostatin receptor subtype-2 （SSTR2）-positive by somatostatin receptor scintigraphy （SRS）. Each patient received 1 -5 cycles of treatment and the interval between two cycles of treatment was 6- 9 weeks. ^90Y-DOTATATE was administered intravenously within 30 min. Lysine was injected before and after the administration of ^90Y-DOTATATE. After each treatment cycle, the side effects were assessed according to National Cancer Institute Grading Criteria （ NCIGC ）. The efficacy was evaluated by the WHO criteria 8 weeks after the last treatment. Results Partial remission was found in 1 patient （4%） , minor response in 3 patients （12%）, stable disease in 16 patients （64%） and tumor progression in 5 patients （20%）. Two patients suffered from renal functional injuries and 3 patients developed leukocytopenia. Three patients showed nausea while another 3 patients presented vomiting. Conclusions ^90 Y-DOTATATE in association with lysine may be a promising treatment method for the patients with metastatic and inoperable neuroendocrine tumors. More research work may be directed to reduce renal injury.

关 键 词：神经内分泌瘤 钇放射性同位素 放射疗法 DOTATATE 

分 类 号：R736[医药卫生—肿瘤]