Abstract: |
Treatment of neuroendocrine tumors (NETs) is typically multidisciplinary and should be individualized according to the tumor histology, lesion extent, patient performance status, and symptoms. Surgery is the only potentially curative option. NET liver metastases are typically hypervascular, and chemoembolization or bland embolization of the hepatic artery, performed mechanically by microspheres or chemically with cytotoxic agents, can lead to significant necrosis. Medical therapy is directed at the control of symptoms and/or reducing tumor growth. Strategies range from the use of bioactive agents (somatostatin analogues or interferon) to conventional chemotherapy. PRRT uses radiolabeled somatostatin analogue peptides to treat unresectable or metastasized NETs. The therapeutic strategy of PRRT has been utilized for more than two decades and is accepted as an effective therapeutic modality in the treatment of inoperable or metastatic GEP, bronchopulmonary, and other NETs. PRRT with either 90Y-DOTATOC or 177Lu-DOTATATE is generally extremely well tolerated, with modest toxicity to the target organs, such as the kidneys and bone marrow. The chapter illustrates the efficacy and safety features of these compounds. © Springer International Publishing Switzerland 2017. All rights reserved. |