Eleonora Pelle, Taymeyah Al-Toubah, Ghassan El-Haddad, Brian Morse, Bhavana Konda, Vineeth Sukrithan, Jonathan Strosberg
{"title":"Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with <sup>177</sup>Lu-DOTATATE.","authors":"Eleonora Pelle, Taymeyah Al-Toubah, Ghassan El-Haddad, Brian Morse, Bhavana Konda, Vineeth Sukrithan, Jonathan Strosberg","doi":"10.1530/EO-25-0033","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lutetium-177 (<sup>177</sup>Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in <sup>177</sup>Lu-DOTATATE-treated patients.</p><p><strong>Methods: </strong>Clinical records were reviewed of patients with midgut NETs treated with <sup>177</sup>Lu-DOTATATE at the Moffitt Cancer Center between April 2018 and December 2022 and at The Ohio State University between December 2017 and October 2020.</p><p><strong>Results: </strong>Among the cases reviewed, we identified three patients who developed bowel ischemia/perforation shortly after their initial treatment with <sup>177</sup>Lu-DOTATATE. All patients had metastatic small bowel NET with prominent mesenteric mass encasing/obstructing the mesenteric vessels and preexisting symptoms of postprandial abdominal pain.</p><p><strong>Conclusion: </strong>Acute bowel ischemia may be a rare complication of PRRT in patients with mesenteric arterial or venous obstruction from mesenteric metastasis.</p>","PeriodicalId":72907,"journal":{"name":"Endocrine oncology (Bristol, England)","volume":"5 1","pages":"e250033"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243096/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine oncology (Bristol, England)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1530/EO-25-0033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Lutetium-177 (177Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in 177Lu-DOTATATE-treated patients.
Methods: Clinical records were reviewed of patients with midgut NETs treated with 177Lu-DOTATATE at the Moffitt Cancer Center between April 2018 and December 2022 and at The Ohio State University between December 2017 and October 2020.
Results: Among the cases reviewed, we identified three patients who developed bowel ischemia/perforation shortly after their initial treatment with 177Lu-DOTATATE. All patients had metastatic small bowel NET with prominent mesenteric mass encasing/obstructing the mesenteric vessels and preexisting symptoms of postprandial abdominal pain.
Conclusion: Acute bowel ischemia may be a rare complication of PRRT in patients with mesenteric arterial or venous obstruction from mesenteric metastasis.