19 research outputs found
Lutetium-labelled peptides for therapy of neuroendocrine tumours
Treatment with radiolabelled somatostatin analogues is a promising new tool in the management of patients with inoperable or metastasized neuroendocrine tumours. Symptomatic improvement may occur with 177Lu-labelled somatostatin analogues that have been used for peptide receptor radionuclide therapy (PRRT). The results obtained with 177Lu-[DOTA0,Tyr3]octreotate (DOTATATE) are very encouraging in terms of tumour regression. Dosimetry studies with 177Lu-DOTATATE as well as the limited side effects with additional cycles of 177Lu-DOTATATE suggest that more cycles of 177Lu-DOTATATE can be safely given. Also, if kidney-protective agents are used, the side effects of this therapy are few and mild and less than those from the use of 90Y-[DOTA0,Tyr3]octreotide (DOTATOC). Besides objective tumour responses, the median progression-free survival is more than 40 months. The patients' self-assessed quality of life increases significantly after treatment with 177Lu-DOTATATE. Lastly, compared to historical controls, there is a benefit in overall survival of several years from the time of diagnosis in patients treated with 177Lu-DOTATATE. These findings compare favourably with the limited number of alternative therapeutic approaches. If more widespread use of PRRT can be guaranteed, such therapy may well become the therapy of first choice in patients with metastasized or inoperable neuroendocrine tumours
Isolated talus metastasis from breast carcinoma: A case report and review of the literature
Background: Acrometastases are very rare and have been identified in
only a few cases on the foot. At the onset, they might be misdiagnosed
as arthritis. Case Report: A 59-year-old woman with isolated metastasis
to the talus, originating from breast carcinoma was treated by
radiotherapy, letrazole, and intravenous bisphosphonates. Results: The
review of the literature revealed that this is the first case of an
isolated metastasis to the bone of talus from a breast carcinoma, while
there are a few cases originating from other organs. The differential
diagnosis of acrometastases may be difficult. Conclusion: Pain in the
foot or hand of a patient with a known history of malignancy should be
considered as potential metastasis
Receptor scintigraphy of non-neuroendocrine cancers with In-111 pentetreotide
Somatostatin receptors (SR) are surface markers characterizing not only
APUDomas associated with neuroendocrine identities but also malignancies
without neuroendocrine expression. Recently, the somatostatin analog
pentetreotide was labeled with In-111 (OctreoScan 111, Mallinckrodt
Medical BV, Petten, Holland) and introduced for the in vivo
visualization in man of SR-positive tissues, In the present report,
SR-specific scintigraphy is evaluated as a clinical tool for tissue
characterization in correlation with histological and radiological
examinations, Scintigraphy was focused and performed in cancer types
without neuroendocrine tissue expression such as brain (n=6) and breast
tumors (n=9) and lymphomas (n=5). Scintigraphy was performed for
comparison at 6 and 22 h after i.v. application of 111 MBq (3 mCi) of
In-111-Pentetreotide. In the breast cancer group, the primary tumor was
visualized in all 9 women as well as in all 4 cases,vith palpable
axillary lymph nodes. Three women with a negative axillary node scan and
impalpable nodes had positive biopsy, In two cases, mediastinal lymph
node involvement was observed, So far the role of SR-positive breast
cancer (BC) scans remains unknown. It is tempting to speculate that in
resected women who are histologically and scintigraphically SR positive,
it might be of value in the early detection of symptom-free recurrences,
High densities of SR were present within both meningiomas, the
high-grade astrocytoma and the craniopharyngioma. Differentiation of
low- and high-grade astrocytomas could not be successfully achieved
because both grades showed intense radioactivity uptake, even though
high-grade tumors lack SR. The latter might be due to the damaged
blood-brain barrier and the poor radioactivity washout observed in
high-grade astrocytomas. All five lymphomas could be detected due to the
presence of activated lymphocytes and macrophages that express SR at a
sufficient density, In conclusion, SR scintigraphy in non-neuroendocrine
malignancies does not seem to be reliable for an initial tumor staging
but rather more suitable for a tissue characterization and extremely
useful for monitoring changes of SR expression after treatment