Stoeltzing, Oliver and Loss, Martin and Huber, Elisabeth and Gross, Volker and Eilles, Christoph and Mueller-Brand, Jan and Schlitt, Hans J. (2010) Staged surgery with neoadjuvant (90)Y-DOTATOC therapy for down-sizing synchronous bilobular hepatic metastases from a neuroendocrine pancreatic tumor. LANGENBECKS ARCHIVES OF SURGERY, 395 (2). pp. 185-192. ISSN 1435-2443,
Full text not available from this repository. (Request a copy)Abstract
Purpose Treatment with DOTA-d-Phe(1)-Tyr(3)-octreotide (DOTATOC), labeled with beta-emitting radioisotope yttrium-90 ((90)Y-DOTATOC), has successfully been used for the palliative treatment of patients with advanced somatostatin receptor-expressing neuroendocrine tumors (NETs). However, controversy persists as to whether patients with metastatic NETs of the pancreas should undergo radical (salvage) surgery or receive palliative therapy. We proposed that (90)Y-DOTATOC could be used in a neoadjuvant intention for improving therapy of hepatic NET metastases. Materials and methods We investigated a novel therapy concept in a 49-year-old patient presenting with a neuroendocrine tumor of the pancreatic tail and synchronous multiple bilobular hepatic metastases. After surgical removal of the large primary tumor by extended left en bloc resection of the pancreatic tail, the patient received neoadjuvant (90)Y-DOTATOC for therapy of primarily non-resectable bilobular hepatic metastases. Results The (90)Y-DOTATOC therapy resulted in an impressive regression of hepatic lesions, thus facilitating surgical removal of all remaining liver metastases in a second operation (staged surgery). In addition, one lesion was ablated using radiofrequency ablation (RFA). At 1-year of follow-up after hepatic R0 resection/RFA, there was no evidence of tumor recurrence or extrahepatic metastasis. Conclusions The neoadjuvant use of (90)Y-DOTATOC therapy could prove valuable for treatment of advanced pancreatic NETs metastatic to the liver in terms of facilitating R0 resection by applying staged surgery concepts.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LONG-TERM SURVIVAL; ENDOCRINE TUMORS; LU-177-DOTATOC; MANAGEMENT; Liver resection; Neoadjuvant therapy; NET; Pancreas; Staged surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Pathologie Medicine > Abteilung für Nuklearmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 10 Aug 2020 07:00 |
| Last Modified: | 10 Aug 2020 07:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/25235 |
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