Dissertation committee:
Καθηγητής Λυμούρης Γεώργιος, Καθηγητής Γουλιάμος Αθανάσιος, Αναπληρώτρια Καθηγήτρια Σταύρακα Αναστασία
Summary:
Purpose: The aim of this study is to evaluate the effectiveness of 111 In-DTPA-
Phe1-
octreotide infusions after selective catheterization of the hepatic artery in
inoperable
metastasised liver, sst2 receptor-positive neuroendocrine tumours, due to the
effect of
111-In Auger electron emission, minimising in parallel the toxicity of
non-target
tissue.
Methods: The average dose per session, administered monthly to each patient, was
4-7 GΒq (17 cases in total). Repetitions did not exceed 12-fold, except in one
case (15
sessions). Response assessment was classified according to the Response
Evaluating
Criteria in Solid Tumours. CT/ MRI scans were performed as baseline before,
during
and after the end of treatment, and monthly ultrasound images for follow-up
measurements. Toxicity (World Health Organization criteria) was measured using
blood and urine tests of renal, hepatic and bone marrow function.
Results: Complete response was achieved in one (5.9%) patient, partial response
in
eight (47.0%), and disease stabilization in 3 (17.7%) patients; five (29.4%)
did not
respond. A 32-month median survival time was estimated in 12 (70.5%). Nine of
these 12 surviving had mean target diameter shrinkage from 144±81 to 60±59 mm.
Grade 1 erythro-, leuko- and thrombo-cytopenia occurred in three (17.6%) cases.
Conclusion: In unresectable metastatic liver lesions positive for somatostatin
receptors repeated, transhepatic high doses of 111In-DTPA- Phe1-octreotide show
an
effective therapeutic outcome. Given the locoregional modality character of the
administration technique plus the extremely short range of 111 In Auger and
internal
conversion electrons emission, no nephro-, liver- or myelo-toxicity has so far
been
observed.
Keywords:
111In-DTPA-D-Phe1-octreotide, Therapeutic infusions, Hepatic artery catheterization, Νeuroendocrine tumours, Liver metastases
