Peptide Receptor Radionuclide Treatment and (131)I-MIBG in the management of patients with metastatic/progressive phaeochromocytomas and paragangliomas

J Surg Oncol. 2017 Mar;115(4):425-434. doi: 10.1002/jso.24553. Epub 2017 Feb 6.

Abstract

Background and objectives: Radionuclide therapy has been used to treat patients with progressive/metastatic paragangliomas (PGLs) and phaeochromocytomas (PCCs). The aim of the present study is to retrospectively compare the therapeutic outcomes of these modalities in patients with progressive/metastatic PCCs and PGLs.

Methods: Patients with progressive/metastatic PGLs and PCCs that were subjected to radionuclide treatment in our department were retrieved from our department's database for the period 1998-2013. Overall survival (OS), progression free survival (PFS), event free survival (EFS), and response to treatment were calculated. Treatment toxicity was documented.

Results: Twenty-two patients with progressive/metastatic PGLs or PCCs were treated with either (131)I-MIBG, (90)Y-DOTATATE or (177)Lu-DOTATATE. A total of 30 treatments were administered (16 treatments with (131)I-MIBG, 2 with (177)Lu-DOTATATE, and 12 with (90)Y-DOTATATE. Patients treated with PRRT had increased PFS and response to treatment compared to (131)I-MIBG treated patients (P < 0.05). However, difference in OS was non significant (P = 0.09). There was no difference in major toxicities between groups. When comparing only patients with PGLs, OS, PFS, EFS, and response to treatment were significantly higher in the PRRT treatment group.

Conclusion: PRRT treatment offers increased OS, PFS, EFS, and response to treatment compared to (131)I-MIBG therapy in patients with progressive/malignant PGLs.

Keywords: (131)I-MIBG; paraganglioma; peptide receptor radionuclide treatment; phaeochromocytoma; radionuclide therapy.

Publication types

  • Comparative Study

MeSH terms

  • 3-Iodobenzylguanidine / therapeutic use*
  • Acute Kidney Injury / etiology
  • Adrenal Gland Neoplasms / mortality
  • Adrenal Gland Neoplasms / therapy*
  • Adult
  • Aged
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Male
  • Middle Aged
  • Octreotide / analogs & derivatives*
  • Octreotide / therapeutic use
  • Organometallic Compounds / therapeutic use*
  • Paraganglioma / mortality
  • Paraganglioma / therapy*
  • Pheochromocytoma / mortality
  • Pheochromocytoma / therapy*
  • Radiopharmaceuticals / therapeutic use
  • Retrospective Studies
  • Yttrium Radioisotopes / therapeutic use

Substances

  • Organometallic Compounds
  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • 3-Iodobenzylguanidine
  • 90Y-octreotide, DOTA-Tyr(3)-
  • lutetium Lu 177 dotatate
  • Octreotide