Factores natriuréticos y biomarcadores de inflamación como predictores de supervivencia en la terapia con [177Lu]Lu-DOTA-TATE de los tumores neuroendocrinos

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2025-04-07 DOI:10.1016/j.remn.2025.500138

A. Piñeiro Donis , L. Menéndez-Muros , J.L. Villa-Palacios , E. Triviño-Ibáñez , M.A. Muros-Fuentes

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引用次数: 0

Abstract

Objective

To analyze the prognostic value of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and other biomarkers of inflammation in patients with neuroendocrine tumors (NETs) treated with [¹⁷⁷Lu]Lu-DOTA-TATE (Lutathera®). The prognostic value of histological characteristics of the tumor was also analyzed.

Patients and methods

Prospective study of a cohort of patients with advanced and metastatic NETs treated with [¹⁷⁷Lu]Lu-DOTA-TATE. Before the administration of doses, NT-proBNP, hemoglobin, hematocrit, C-reactive protein, leukocytes, lymphocytes, neutrophils, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been determined. Overall survival (OS) and progression free survival (PFS) were calculated, using the Kaplan-Meier method, and curves were compared with a log-rank test. To determine the predictor variables of OS, a Cox regression model was fitted.

Results

48 NET patients treated with [¹⁷⁷Lu]Lu-DOTA-TATE. Median OS was 96 months and PFS was 29 months. Factors associated with lower OS were: NTproBNP values > 300 pg/mL (HR: 10.5; P = .005) in the subgroup of patients with grades 2-3, in addition to inflammatory indices NLR > 2 (HR: 3.87; P = .049) and PLR > 300 (HR: 11.88; P = .01) and higher tumor grade (HR: 6.45; P = .011). PLR > 300 (HR: 5.506; P = .003) was also associated with lower PFS. In contrast, higher levels of lymphocytes (HR: 0.21; P = .002), hemoglobin (HR: 0.65; P = .041) and hematocrit (HR: 0.862; P = .031) were associated with higher OS, without significant changes in PFS.

Conclusion

In patients with NETs treated with [¹⁷⁷Lu]Lu-DOTA-TATE, the determination of natriuretic factors (NT-ProBNP) and other inflammatory biomarkers may be useful as predictors of survival and prognostic factors.

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钠尿因子和炎症生物标志物作为神经内分泌肿瘤[177Lu]Lu-DOTA-TATE治疗生存率的预测指标

目的分析脑利钠肽n端原激素（NT-proBNP）及其他炎症生物标志物在应用[177Lu]Lu-DOTA-TATE （Lutathera®）治疗神经内分泌肿瘤（NETs）患者中的预后价值。并分析肿瘤的组织学特征对预后的影响。患者和方法一组接受[177Lu]Lu-DOTA-TATE治疗的晚期和转移性NETs患者的前瞻性研究。给药前，测定NT-proBNP、血红蛋白、红细胞压积、c反应蛋白、白细胞、淋巴细胞、中性粒细胞、中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）。采用Kaplan-Meier法计算总生存期（OS）和无进展生存期（PFS），并用log-rank检验比较曲线。为确定OS的预测变量，拟合Cox回归模型。结果48例NET患者采用[177Lu]Lu-DOTA-TATE治疗。中位OS为96个月，PFS为29个月。与较低OS相关的因素有：2-3级患者亚组NTproBNP值>； 300 pg/mL (HR: 10.5; P = 0.005)，炎症指数NLR >； 2 （HR: 3.87; P = 0.049）和PLR >； 300 （HR: 11.88; P = 0.01）和较高的肿瘤分级（HR: 6.45; P = 0.011）。PLR > 300 （HR: 5.506; P = 0.003）也与较低的PFS相关。相比之下，淋巴细胞（HR: 0.21, P = 0.002）、血红蛋白（HR: 0.65, P = 0.041）和红细胞压积（HR: 0.862, P = 0.031）水平升高与OS升高相关，PFS无显著变化。结论在接受[177Lu]Lu-DOTA-TATE治疗的NETs患者中，利钠因子（NT-ProBNP）和其他炎症生物标志物的测定可能有助于预测生存和预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.