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- 177Lu- DOTATATE; 177Lu-octreotate; carcinoma neuroendocrino; gastroenteropancreatic neuroendocrine tumor; receptores de somatostatina; Carcinoma neuroendocrino; Medicina nuclear::Investigaciones; Neoplasias pancreáticas; Octreótido::Utilización; Tumores neuroendocrinos::Diagnóstico; TUMORES NEUROENDOCRINOS - TRATAMIENTO; CARCINOMA NEUROENDOCRINO; MEDICINA NUCLEAR - INVESTIGACIONES; NEOPLASIAS PANCREÁTICAS; OCTREÓTIDO - UTILIZACIÓN; TUMORES NEUROENDOCRINOS - DIAGNÓSTICO
thesis / dissertation description
Gastroenteropancreatic neuroendocrine tumors are diagnosed in advanced state in approximately 60 – 80% of patients, their treatment options are limited. We reviewed the clinical benefit of radionuclide therapy with 177Lu – DOTA – Tyr3] – Octreotate in patients with advanced or inoperable disease. Objective: To assess the efficacy, impact on quality of life and side effects of therapy with 177Lu DOTATE in patients with advanced gastroenteropancreatic neuroendocrine tumors. Materials and Methods: We conducted a systematic review using a peer – reviewed search for clinical prospective and retrospective trials. This search was done in electronic databases (MEDLINE, EMBASE, LILACS, SCIELO, OVID and the Cochrane Library) without language, year or publication status limitations. We included 5 studies; because they were heterogeneous no meta analysis was done. Results: Overall tumor response was seen in 45- 57% of cases, stable disease in 27-38% and progression in 6-21% of cases included in the studies. Time to progression was 31 - 40 months and overall survival 31 – 51 months. Hematologic toxicity grade 3-4 presented in up to 9.5% of patients. Treatment had a significant positive impact in quality of life. Conclusions: Therapy with 177Lu- DOTATATE offers a clinical benefit to patients with advanced gastroenteropancreatic neuroendocrine tumors by improving quality of life, controlling symptoms and limiting progression of disease. The toxicity of the drug is low.