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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-04-2008 | Original article

Hormonal crises following receptor radionuclide therapy with the radiolabeled somatostatin analogue [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotate

Authors: Bart de Keizer, Maarten O. van Aken, Richard A. Feelders, Wouter W. de Herder, Boen L. R. Kam, Martijn van Essen, Eric P. Krenning, Dik J. Kwekkeboom

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2008

Abstract

Introduction

Receptor radionuclide therapy is a promising treatment modality for patients with neuroendocrine tumors for whom alternative treatments are limited. The aim of this study was to investigate the incidence of hormonal crises after therapy with the radiolabeled somatostatin analogue [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotate (¹⁷⁷Lu-octreotate).

Materials and methods

All ¹⁷⁷Lu-octreotate treatments between January 2000 and January 2007 were investigated. Four hundred seventy-six patients with gastroenteropancreatic neuroendocrine tumors and three patients with metastatic pheochromocytoma were included for analysis.

Results

Four hundred seventy-nine patients received a total of 1,693 administrations of ¹⁷⁷Lu-octreotate. Six of 479 patients (1%) developed severe symptoms because of massive release of bioactive substances after the first cycle of ¹⁷⁷Lu-octreotate. One patient had a metastatic hormone-producing small intestinal carcinoid; two patients had metastatic, hormone-producing bronchial carcinoids; two patients had vasoactive intestinal polypeptide-producing pancreatic endocrine tumors (VIPomas); and one patient had a metastatic pheochromocytoma. With adequate treatment, all patients eventually recovered.

Conclusion

Hormonal crises after ¹⁷⁷Lu-octreotate therapy occur in 1% of patients. Generally, ¹⁷⁷Lu-octreotate therapy is well tolerated.

Karmy-Jones R, Vallieres E. Carcinoid crisis after biopsy of a bronchial carcinoid. Ann Thorac Surg. 1993;56:1403-5.CrossRefPubMed

Kharrat HA, Taubin H. Carcinoid crisis induced by external manipulation of liver metastasis. J Clin Gastroenterol. 2003;36:87-8.CrossRefPubMed

Ozgen A, Demirkazik FB, Arat A, Arat AR. Carcinoid crisis provoked by mammographic compression of metastatic carcinoid tumour of the breast. Clin Radiol. 2001;56:250-1.CrossRefPubMed

Vaughan DJA, Brunner MD. Anesthesia for patients with carcinoid syndrome. Int Anesthesiol Clin. 1997;35:129-42.CrossRefPubMed

Salm EF, Janssen M, Breburda CS, van Woerkens LJPM, de Herder WW, Zwaan Cvd, et al. Carcinoid crisis during transesophageal echocardiography. Intensive Care Med. 2000;26:254-54.CrossRefPubMed

Lips CJ, Lentjes EG, Hoppener JW. The spectrum of carcinoid tumours and carcinoid syndromes. Ann Clin Biochem. 2003;40:612-27.CrossRefPubMed

Davi MV, Bodei L, Francia G, Bartolomei M, Oliani C, Scilanga L, et al. Carcinoid crisis induced by receptor radionuclide therapy with 90Y-DOTATOC in a case of liver metastases from bronchial neuroendocrine tumor (atypical carcinoid). J Endocrinol Invest. 2006;29:563-7.CrossRefPubMed

Kaltsas GA, Papadogias D, Grossman AB. The clinical presentation (symptoms and signs) of sporadic and familial chromaffin cell tumours (phaeochromocytomas and paragangliomas). Front Horm Res. 2004;31:61-75.CrossRefPubMed

Kwekkeboom DJ, Teunissen JJ, Bakker WH, Kooij PP, de Herder WW, Feelders RA, et al. Radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate in patients with endocrine gastroenteropancreatic tumors. J Clin Oncol. 2005;23:2754-62.CrossRefPubMed

10.

Kwekkeboom DJ, Bakker WH, Kooij PP, Konijnenberg MW, Srinivasan A, Erion JL, et al. [177Lu-DOTAOTyr3]octreotate: comparison with [111In-DTPAo]octreotide in patients. Eur J Nucl Med. 2001;28:1319-25.CrossRefPubMed

11.

Bloom SR, Yiangou Y, Polak JM. Vasoactive intestinal peptide secreting tumors. Pathophysiological and clinical correlations. Ann N Y Acad Sci. 1988;527:518-27.CrossRefPubMed

12.

Caplin ME, Buscombe JR, Hilson AJ, Jones AL, Watkinson AF, Burroughs AK. Carcinoid tumour. Lancet. 1998;352:799-805.CrossRefPubMed

13.

Kizer JR, Koniaris LS, Edelman JD, St. John Sutton MG. Pheochromocytoma crisis, cardiomyopathy, and hemodynamic collapse. Chest. 2000;118:1221-3.CrossRefPubMed

14.

Werbel SS, Ober KP. Pheochromocytoma. Update on diagnosis, localization, and management. Med Clin North Am. 1995;79:131-53.CrossRefPubMed

15.

Sasaki M, Iwaoka T, Yamauchi J, Tokunaga H, Naomi S, Inoue J, et al. A case of Sipple’s syndrome with malignant pheochromocytoma treated with 131I-metaiodobenzyl guanidine and a combined chemotherapy with cyclophosphamide, vincristine and dacarbazine. Endocr J. 1994;41:155-60.CrossRefPubMed

16.

Safford SD, Coleman RE, Gockerman JP, Moore J, Feldman JM, Leight GS, et al. Iodine-131 metaiodobenzylguanidine is an effective treatment for malignant pheochromocytoma and paraganglioma. Surgery 2003;134:956-62.CrossRefPubMed

17.

Bell HK, Poston GJ, Vora J, Wilson NJ. Cutaneous manifestations of the malignant carcinoid syndrome. Br J Dermatol. 2005;152:71-5.CrossRefPubMed

18.

Frojd C, Larsson G, Lampic C, von Essen L. Health related quality of life and psychosocial function among patients with carcinoid tumours. A longitudinal, prospective, and comparative study. Health Qual Life Outcomes. 2007;5:18.CrossRefPubMedPubMedCentral

19.

Rolleman EJ, Kooij PP, de Herder WW, Valkema R, Krenning EP, de Jong M. Somatostatin receptor subtype 2-mediated uptake of radiolabelled somatostatin analogues in the human kidney. Eur J Nucl Med Mol Imaging 2007;34(11):1854-60.CrossRefPubMed

20.

de Herder WW, Lamberts SW. Somatostatin and somatostatin analogues: diagnostic and therapeutic uses. Curr Opin Oncol. 2002;14:53-7.CrossRefPubMed

21.

Oberg K, Kvols L, Caplin M, Delle Fave G, de Herder W, Rindi G, et al. Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system. Ann Oncol. 2004;15:966-73.CrossRefPubMed

22.

Kvols LK, Martin JK, Marsh HM, Moertel CG. Rapid reversal of carcinoid crisis with a somatostatin analogue. N Engl J Med. 1985;313:1229-30.PubMed

23.

Warner RR, Mani S, Profeta J, Grunstein E. Octreotide treatment of carcinoid hypertensive crisis. Mt Sinai J Med. 1994;61:349-55.PubMed

Title: Hormonal crises following receptor radionuclide therapy with the radiolabeled somatostatin analogue [177Lu-DOTA0,Tyr3]octreotate
Authors: Bart de Keizer
Maarten O. van Aken
Richard A. Feelders
Wouter W. de Herder
Boen L. R. Kam
Martijn van Essen
Eric P. Krenning
Dik J. Kwekkeboom
Publication date: 01-04-2008
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-007-0691-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hormonal crises following receptor radionuclide therapy with the radiolabeled somatostatin analogue [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotate

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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