Treatment of Gastrointestinal and Pancreatic Neuroendocrine Neoplasms by Radionuclide Therapy: Practice and Experience
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摘要: 肽受体放射性核素治疗(peptide receptor radionuclide therapy,PRRT)可缓解神经内分泌肿瘤(neuroendocrine neoplasms, NENs)患者症状、提高患者生活质量,且治疗耐受性良好,是NENs目前先进的治疗方法之一。由于该治疗在国内刚起步,如何为PRRT患者提供规范、高效、优质的治疗服务尚存在诸多值得商榷之处。本文在参考国外指南和临床规范的基础之上,结合西南医科大学附属医院开展177Lu-DOTATATE治疗NENs的实践经验,总结相关治疗要点、常见不良反应预防及患者心理干预措施,以期为临床诊疗提供借鉴。
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关键词:
- 177Lu-DOTATATE /
- 肽受体放射性核素治疗 /
- 神经内分泌肿瘤 /
- 生长抑素受体 /
- 核医学
Abstract: Peptide receptor radionuclide therapy (PRRT) is one of the advanced therapies for neuroendocrine neoplasms (NENs), which can relieve the symptoms and improve the quality of life of patients with NENs with good tolerance to the treatment.However, since this treatment method has just started in China, how to implement standardized, efficient and high-quality nursing services for patients undergoing PRRT is still worth discussing. By referring to related international guidelines and clinical nursing standards, and combining our experience in the treatment of NENs using 177Lu-DOTATATE, we proposed the key nursing points during the treatment process, and elaborated how to prevent common adverse reactions and undergo psychological intervention, in hope of the related personnel being able to provide more safe treatment and to improve nursing security.作者贡献:雷蕾、杜涛、欧霞负责论文初稿撰写及患者治疗;朱艳、张瑜负责文献查阅与治疗流程制订;张伟负责论文设计、内容修订与审核,并参与治疗流程制订。利益冲突:所有作者均声明不存在利益冲突 -
[1] 中华医学会消化病学分会胃肠激素与神经内分泌肿瘤学组. 胃肠胰神经内分泌肿瘤诊治专家共识(2020·广州)[J]. 中华消化杂志, 2021, 41: 76-87. [2] Bodei L, Mueller-Brand J, Baum RP, et al. The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours[J]. Eur J Nucl Med Mol Imaging, 2013, 40: 800-816. doi: 10.1007/s00259-012-2330-6 [3] 刘会攀, 陈跃. 放射性核素诊治神经内分泌肿瘤的应用进展[J]. 中华核医学与分子影像杂志, 2019, 39: 564-567. doi: 10.3760/cma.j.issn.2095-2848.2019.09.015 [4] Feijtel D, de Jong M, Nonnekens J. Peptide Receptor Radionuclide Therapy: Looking Back, Looking Forward[J]. Curr Top Med Chem, 2020, 20: 2959-2969. doi: 10.2174/1568026620666200226104652 [5] Ezziddin S, Attassi M, Yong-Hing CJ, et al. Predictors of long-term outcome in patients with well-differentiated gastroenteropancreatic neuroendocrine tumors after peptide receptor radionuclide therapy with 177Lu-octreotate[J]. J Nucl Med, 2014, 55: 183-190. doi: 10.2967/jnumed.113.125336 [6] Strosberg J, El-Haddad G, Wolin E, et al. Phase 3 Trial of (177)Lu-Dotatate for Midgut Neuroendocrine Tumors[J]. N Engl J Med, 2017, 376: 125-135. doi: 10.1056/NEJMoa1607427 [7] Nicolini S, Severi S, Ianniello A, et al. Investigation of receptor radionuclide therapy with (177)Lu-DOTATATE in patients with GEP-NEN and a high Ki-67 proliferation index[J]. Eur J Nucl Med Mol Imaging, 2018, 45: 923-930. doi: 10.1007/s00259-017-3925-8 [8] Perren A, Couvelard A, Scoazec JY, et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pathology: Diagnosis and Prognostic Stratification[J]. Neuroendocrinology, 2017, 105: 196-200. doi: 10.1159/000457956 [9] Costa F, Gumz B. Octreotide - A Review of its Use in Treating Neuroendocrine Tumours[J]. Eur Endocrinol, 2014, 10: 70-74. [10] Calais PJ, Turner JH. Radiation safety of outpatient 177Lu-octreotate radiopeptide therapy of neuroendocrine tumors[J]. Ann Nucl Med, 2014, 28: 531-539. doi: 10.1007/s12149-014-0843-8 [11] 王国慧, Lau E, Shakher R, 等. 177Lu-octreotate治疗神经内分泌胃肠胰腺肿瘤的SPECT显像研究[J]. 中华核医学杂志, 2007, 27: 313-314. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHY200705031.htm [12] Erbas B, Tuncel M. Renal Function Assessment During Peptide Receptor Radionuclide Therapy[J]. Semin Nucl Med, 2016, 46: 462-478. doi: 10.1053/j.semnuclmed.2016.04.006 [13] Shaheen S, Moradi F, Gamino G, et al. Patient Selection and Toxicities of PRRT for Metastatic Neuroendocrine Tumors and Research Opportunities[J]. Curr Treat Options Oncol, 2020, 21: 25. doi: 10.1007/s11864-020-0711-9 [14] Makis W, McCann K, McEwan AJ. The Challenges of Treating Paraganglioma Patients with 177Lu-DOTATATE PRRT: Catecholamine Crises, Tumor Lysis Syndrome and the Need for Modification of Treatment Protocols[J]. Nucl Med Mol Imaging, 2015, 49: 223-230. doi: 10.1007/s13139-015-0332-6 [15] 范素云, 柴丽, 贾彦彦, 等. 131I治疗期间甲状腺癌患者未满足的照顾需求分析[J]. 中华核医学与分子影像杂志, 2018, 38: 422-424.
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