THERANOSTICS in Neuroendocrine Tumors

Theranostics

¹⁷⁷Lutetium-DOTATATE

Therapeutic radioactive doses for Neuroendocrine Tumors

Peptide-Receptor Radionuclide therapy (PRRT)

General Concept

Neuro-endocrine tumors have somatostatin receptors on their surface.
We perform diagnostic PET/CT study using ⁶⁸Gallium-DOTATATE to detect tumors in the body and confirm presence of receptors on tumor cells.
We then inject the therapeutic dose (¹⁷⁷Lutetium-DOTATATE).¹⁷⁷Lutetium emits short ranged Beta rays of average length of 0.23mm leading to tumor cell damage and at the same time low risk to surrounding healthy cells.

How it works?

The therapy is indicated in patients with metastatic neuroendocrine tumors (grade 1 and grade 2).
The treatment is composed of 4 intra-venous doses, one dose every 2 months.
It is performed as an outpatient procedure; the whole process takes about 4-5 hours.

Post procedure radiation safety:

Patients should be encouraged to drink large quantities of water in first 2 days (1 glass every 2 hours).
For the first 3 days:
- Restricted contact with adults to a maximum of 6 hours per/day of close contact <1 meter.
- Avoid contact with children and pregnant women (then restricted contact for further 3 days).

What is the eligibility criteria?

High somatostatin receptor expression based on Gallium-DOTATATE PET/CT scan.
Adequate bone marrow, renal and hepatic functions.
Avoid administering long acting octreotide for 4 weeks prior to therapy.
Exclude urinary outflow obstruction.

What are the expected results?

The results of NETTER-1 trial showed that ¹⁷⁷Lu-DOTATATE had a 79% reduction in risk of progression.
Estimated progression free survival of 40 months, compared with only 8.4 months for high-dose (60mg) octreotide therapy.

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