Etablierung und Qualitätskontrolle der Radioligandentherapie mit Yttrium-90 und Lutetium-177 zur Behandlung neuroendokriner Tumoren am Uniklinikum Marburg

Neuroendocrine tumors are rare and heterogene neoplasias. A great member of patients show a stage of distant metastases already at the time of diagnosis, when there is no more possibility of curative surgical therapy. Drug therapy with somatostatin analogues has a proved antiproliferative effect besides the symptom control and is often used in the treatment of NET-patients. In general chemotherapy is merely restrictedly applicable because of the slow growth of neuroendocrine tumors. Another option for the treatment is a therapy with molecular targeting for example of the angiogenesis, of mTOR, of tyrosincinasis or growth factors. At the Universitätsklinikum of Marburg 35 patients with metastatic neuroendocrine tumors were treated with a radionuclide therapy in the time of 2009 to 2012. In these cases Yttrium-90-DOTATOC or Lutetium-177-DOTATOC were used as radiopharmceuticals. The aim of this study was to analyse the quality and clinical safety of this therapy in comparison to the published results of other Centers. Therefore a retrospective analyis of patients data was made. Referring to the patient characteristics no evident differences could be stated among the two groups. Acute side effects of the therapy could be treated rather efficiently. Despite the encouring results so far, further optimizations of the radionuclide therapy should be developed. Future developments include the application ov individualised methods for dosimetry and the development of new nephroprotective substances to minimize the toxic effects of the therapy. On the other hand new somatostatin analogues and antagonists with improved binding properties and a wider spectrum of targeted receptors are being developed.