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Luca Filippi,Alida Ciorra,Barbara Sardella,Orazio Schillaci,Oreste Bagni 대한핵의학회 2014 핵의학 분자영상 Vol.48 No.4
Abstract 90Y radioembolization and peptide-receptor radionuclidetherapy (PRRT) with177Lu-DOTATATE are both effectivetreatments for patients with inoperable neuroendocrinemetastatic tumors (NET). We report the case of a 72-year-oldman with severe functional syndrome due to a metastaticNET. 68Ga-DOTATOC positron-emission tomography (PET)revealed high somatostatin receptor expression in a gross livermetastasis, in one abdominal lymph node and in severals k e l e t a l l esions. The patient underwent l iverradioembolization with 90Y-resin microspheres followed byfour cycles of PRRT with177Lu-DOTATATE. After 3 months,a complete remission of the functional syndrome was observed. 68Ga-DOTATOC PET demonstrated a complete responsefor skeletal and lymph nodal lesions with a residualbulky mass in the liver. Therefore a further 90Yradioembolization was performed as consolidation treatmentfor the hepatic lesion. Six months after these combined treatments,68Ga-DOTATOC PET demonstrated complete metabolicresponse in liver and stable extrahepatic lesions. Nosignificant long-term adverse reactions were registered. Toour knowledge, the sequential use of 90Y radiembolizationbefore and after PRRT in a liver-dominant advanced NET hasnot been reported in the literature and this case suggests thatthese combined treatments can be safe and effective.