肺神经内分泌肿瘤患者的放射性配体疗法:疗效与安全性系统综述》。

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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引用次数: 0

摘要

来自不同部位的神经内分泌肿瘤(NENs)给治疗带来了挑战。放射性配体疗法(RLT)对体生长抑素受体摄取增加的不可切除/转移性神经内分泌瘤有效。虽然有证据表明 RLT 对中肠 NET 有疗效,但其在肺 NET 中的作用仍未得到充分探索。临床指南将 RLT 作为这种情况下的三线或四线选择。然而,在过去几年中,有几项研究主要是回顾性地调查了RLT在肺NET中的有效性和安全性。本综述旨在评估 RLT 对肺 NET 患者的有效性和安全性。根据PRISMA指南,我们对MEDLINE和EMBASE数据库进行了系统性回顾,检索了截至2023年3月31日的英文文章。纳入标准包括RLT治疗肺NET的疗效和安全性评估研究。符合标准的研究有 27 项,共计 786 名患者。汇总分析显示,客观反应率为25.6%,疾病控制率为75.6%。无进展生存期中位数平均为20个月,总生存期平均为45个月。影响反应的因素包括肿瘤负荷、之前的治疗、18F-FDG PET 扫描摄取量和组织学变异。RLT出现了可控的1/2级不良反应,主要是血液学不良反应,其中Lu177的不良反应比Y90更严重。研究结果支持RLT对肺NET的有效性,为晚期SSTR阳性患者带来了希望。尽管确定反应的预测因素仍具有挑战性,但RLT在既往治疗后仍能保持疗效,而且典型类癌的反应略好于非典型类癌。前瞻性试验对于确定RLT的确切疗效及其在肺NET治疗中的地位至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radioligand Therapy in Patients with Lung Neuroendocrine Tumors: A Systematic Review on Efficacy and Safety

Neuroendocrine neoplasms (NENs), arising from various sites, present therapeutic challenges. Radioligand therapy (RLT) is effective for unresectable/metastatic NENs with increased somatostatin receptor uptake. While evidence supports RLT's efficacy in midgut NETs, its role in lung NETs remains underexplored. Clinical guidelines place RLT as a third or fourth-line option in this setting. However, in the last years several studies investigated mainly retrospectively effectiveness and safety of RLT in lung NET. The aim of this review is to assess the efficacy and safety of RLT in patients with lung NETs. Following PRISMA guidelines, a systematic review of MEDLINE and EMBASE databases retrieved English articles until March 31, 2023. Inclusion criteria encompassed studies involving RLT in lung NETs with efficacy and safety assessments. Twenty-seven studies met the criteria, totaling 786 patients. The pooled analysis revealed a 25.6% objective response rate and 75.6% disease control rate. Median progression-free survival averaged 20 months, while overall survival averaged 45 months. Factors affecting response included tumor burden, prior treatments, 18F-FDG PET scan uptake, and histological variants. RLT exhibited manageable grade 1/2 adverse effects, predominantly hematological, with Lu177 demonstrating a more favorable profile than Y90. The findings support RLT's effectiveness in lung NETs, offering hope for advanced SSTR-positive patients. Although identifying predictive factors for response remains challenging, RLT retained efficacy even after prior therapies and typical carcinoids displayed a slightly better response than atypical ones. Prospective trials are imperative to establish RLT's definitive efficacy and its place in the therapeutic landscape for lung NETs.

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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
期刊介绍: Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.
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