Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: The role of associated risk factors

Lisa Bodei, Marta Cremonesi, Mahila Ferrari, Monica Pacifici, Chiara M. Grana, Mirco Bartolomei, Silvia M. Baio, Maddalena Sansovini, Giovanni Paganelli

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Abstract

Purpose: Peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumours with 90Y-DOTATOC and 177Lu-DOTATATE is promising. The kidney is the critical organ and despite renal protection, function loss may become evident years later. The aim of this study was to analyse renal parameters in patients who had undergone dosimetry before PRRT. Methods: Among those in protocols at our institution, 28 patients were considered: 23 received 90Y-DOTATOC (3.8-29.2 GBq, median 12.2) and five received 177Lu-DOTATATE (20.7-29.2 GBq, median 23.2). Patients were followed up after therapy for creatinine and creatinine clearance loss (CCL) for 3-97 months (median 30). Renal doses and bio-effective doses (BED) were calculated (MIRD, LQ model). Results: After 90Y-DOTATOC toxicity on creatinine according to NCI criteria occurred in nine cases (seven grade 1, one grade 2, one grade 3), CCL at 1 year was >5% in 12 cases and >10% in eight. A 28-Gy BED threshold was observed in patients with risk factors (mainly hypertension and diabetes), while it was 40 Gy in patients without risk factors. Probably due to the low number of patients, despite the absence of severe toxicity after hyper-fractionated PRRT, clear correlations between fractionation and toxicity could not be found. After 177Lu-DOTATATE, no toxicity occurred in 1-2 year follow-up; CCL at 1 year >5% occurred in three patients and >10% in two. Conclusions: Our results indicate the importance of clinical screening for risk factors: In this case, a BED

Original languageEnglish
Pages (from-to)1847-1856
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume35
Issue number10
DOIs
Publication statusPublished - Oct 2008

Fingerprint

Peptide Receptors
Radioisotopes
Kidney
Creatinine
Therapeutics
Neuroendocrine Tumors
(177lutetium-DOTA(O)Tyr3)octreotate
DOTA-Tyr(3)-90Y-octreotide
Hypertension

Keywords

  • Lu-DOTATATE
  • Y-DOTATOC
  • Dosimetry
  • Radionuclide therapy
  • Renal toxicity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{bc195c6c2c6243198263406108d58b4a,
title = "Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: The role of associated risk factors",
abstract = "Purpose: Peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumours with 90Y-DOTATOC and 177Lu-DOTATATE is promising. The kidney is the critical organ and despite renal protection, function loss may become evident years later. The aim of this study was to analyse renal parameters in patients who had undergone dosimetry before PRRT. Methods: Among those in protocols at our institution, 28 patients were considered: 23 received 90Y-DOTATOC (3.8-29.2 GBq, median 12.2) and five received 177Lu-DOTATATE (20.7-29.2 GBq, median 23.2). Patients were followed up after therapy for creatinine and creatinine clearance loss (CCL) for 3-97 months (median 30). Renal doses and bio-effective doses (BED) were calculated (MIRD, LQ model). Results: After 90Y-DOTATOC toxicity on creatinine according to NCI criteria occurred in nine cases (seven grade 1, one grade 2, one grade 3), CCL at 1 year was >5{\%} in 12 cases and >10{\%} in eight. A 28-Gy BED threshold was observed in patients with risk factors (mainly hypertension and diabetes), while it was 40 Gy in patients without risk factors. Probably due to the low number of patients, despite the absence of severe toxicity after hyper-fractionated PRRT, clear correlations between fractionation and toxicity could not be found. After 177Lu-DOTATATE, no toxicity occurred in 1-2 year follow-up; CCL at 1 year >5{\%} occurred in three patients and >10{\%} in two. Conclusions: Our results indicate the importance of clinical screening for risk factors: In this case, a BED",
keywords = "Lu-DOTATATE, Y-DOTATOC, Dosimetry, Radionuclide therapy, Renal toxicity",
author = "Lisa Bodei and Marta Cremonesi and Mahila Ferrari and Monica Pacifici and Grana, {Chiara M.} and Mirco Bartolomei and Baio, {Silvia M.} and Maddalena Sansovini and Giovanni Paganelli",
year = "2008",
month = "10",
doi = "10.1007/s00259-008-0778-1",
language = "English",
volume = "35",
pages = "1847--1856",
journal = "European Journal of Pediatrics",
issn = "0340-6199",
publisher = "Springer Berlin Heidelberg",
number = "10",

}

TY - JOUR

T1 - Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE

T2 - The role of associated risk factors

AU - Bodei, Lisa

AU - Cremonesi, Marta

AU - Ferrari, Mahila

AU - Pacifici, Monica

AU - Grana, Chiara M.

AU - Bartolomei, Mirco

AU - Baio, Silvia M.

AU - Sansovini, Maddalena

AU - Paganelli, Giovanni

PY - 2008/10

Y1 - 2008/10

N2 - Purpose: Peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumours with 90Y-DOTATOC and 177Lu-DOTATATE is promising. The kidney is the critical organ and despite renal protection, function loss may become evident years later. The aim of this study was to analyse renal parameters in patients who had undergone dosimetry before PRRT. Methods: Among those in protocols at our institution, 28 patients were considered: 23 received 90Y-DOTATOC (3.8-29.2 GBq, median 12.2) and five received 177Lu-DOTATATE (20.7-29.2 GBq, median 23.2). Patients were followed up after therapy for creatinine and creatinine clearance loss (CCL) for 3-97 months (median 30). Renal doses and bio-effective doses (BED) were calculated (MIRD, LQ model). Results: After 90Y-DOTATOC toxicity on creatinine according to NCI criteria occurred in nine cases (seven grade 1, one grade 2, one grade 3), CCL at 1 year was >5% in 12 cases and >10% in eight. A 28-Gy BED threshold was observed in patients with risk factors (mainly hypertension and diabetes), while it was 40 Gy in patients without risk factors. Probably due to the low number of patients, despite the absence of severe toxicity after hyper-fractionated PRRT, clear correlations between fractionation and toxicity could not be found. After 177Lu-DOTATATE, no toxicity occurred in 1-2 year follow-up; CCL at 1 year >5% occurred in three patients and >10% in two. Conclusions: Our results indicate the importance of clinical screening for risk factors: In this case, a BED

AB - Purpose: Peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumours with 90Y-DOTATOC and 177Lu-DOTATATE is promising. The kidney is the critical organ and despite renal protection, function loss may become evident years later. The aim of this study was to analyse renal parameters in patients who had undergone dosimetry before PRRT. Methods: Among those in protocols at our institution, 28 patients were considered: 23 received 90Y-DOTATOC (3.8-29.2 GBq, median 12.2) and five received 177Lu-DOTATATE (20.7-29.2 GBq, median 23.2). Patients were followed up after therapy for creatinine and creatinine clearance loss (CCL) for 3-97 months (median 30). Renal doses and bio-effective doses (BED) were calculated (MIRD, LQ model). Results: After 90Y-DOTATOC toxicity on creatinine according to NCI criteria occurred in nine cases (seven grade 1, one grade 2, one grade 3), CCL at 1 year was >5% in 12 cases and >10% in eight. A 28-Gy BED threshold was observed in patients with risk factors (mainly hypertension and diabetes), while it was 40 Gy in patients without risk factors. Probably due to the low number of patients, despite the absence of severe toxicity after hyper-fractionated PRRT, clear correlations between fractionation and toxicity could not be found. After 177Lu-DOTATATE, no toxicity occurred in 1-2 year follow-up; CCL at 1 year >5% occurred in three patients and >10% in two. Conclusions: Our results indicate the importance of clinical screening for risk factors: In this case, a BED

KW - Lu-DOTATATE

KW - Y-DOTATOC

KW - Dosimetry

KW - Radionuclide therapy

KW - Renal toxicity

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