Pituitary function after high-dose 177Lu-DOTATATE therapy and long-term follow-up
(2021) In Neuroendocrinology p.344-353- Abstract
INTRODUCTION: The pituitary gland has a high expression of somatostatin receptors (SSTRs) and is therefore a potential organ at risk for radiation-induced toxicity after 177Lu-DOTATATE treatment.
OBJECTIVE: To study changes in pituitary function in patients with neuroendocrine tumors (NETs) treated with dosimetry-based 177Lu-DOTATATE to detect possible late toxicity.
METHODS: 68 patients from a phase II clinical trial of dosimetry-based, individualized 177Lu-DOTATATE-therapy were included in this analysis. Patients had received a median of 5 (range 3-9) treatment cycles of 7.4 GBq/cycle. Median follow-up was 30 months (range 11-89). The GH/IGF1-axis, gonadotropins, adrenal and thyroid axes were analyzed from baseline and on... (More)
INTRODUCTION: The pituitary gland has a high expression of somatostatin receptors (SSTRs) and is therefore a potential organ at risk for radiation-induced toxicity after 177Lu-DOTATATE treatment.
OBJECTIVE: To study changes in pituitary function in patients with neuroendocrine tumors (NETs) treated with dosimetry-based 177Lu-DOTATATE to detect possible late toxicity.
METHODS: 68 patients from a phase II clinical trial of dosimetry-based, individualized 177Lu-DOTATATE-therapy were included in this analysis. Patients had received a median of 5 (range 3-9) treatment cycles of 7.4 GBq/cycle. Median follow-up was 30 months (range 11-89). The GH/IGF1-axis, gonadotropins, adrenal and thyroid axes were analyzed from baseline and on a yearly basis thereafter. Percent changes in hormonal levels over time were analyzed statistically using a linear mixed model and described graphically using boxplots. The absorbed radiation dose to the pituitary was estimated based on post-therapeutic imaging, and the results analyzed vs % change in IGF1-levels over time.
RESULTS: A statistically significant decrease in the levels of IGF1 was found (p<0.005), which was correlated to the number of treatment cycles (p=0.008) and absorbed radiation dose (p=0.03). A similar decrease, although non-significant, was seen in the gonadotropins in post-menopausal women, while in men there was an increase during the first years post-therapy, after which the levels returned to baseline. No change was observed in the adrenal nor thyroid axes.
CONCLUSIONS: No signs of severe endocrine disorder were detected, although a significant decrease in the GH/IGF1-axis was found, where dosimetric analyses indicate radiation-induced damage to the pituitary gland as a probable cause.
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- author
- Sundlöv, Anna LU ; Sjögreen-Gleisner, Katarina LU ; Tennvall, Jan LU ; Dahl, Ludvig LU ; Svensson, Johanna ; Åkesson, Anna ; Bernhardt, Peter and Lindgren, Ola LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Neuroendocrinology
- pages
- 10 pages
- publisher
- Karger
- external identifiers
-
- scopus:85103148381
- pmid:32259830
- ISSN
- 0028-3835
- DOI
- 10.1159/000507761
- language
- English
- LU publication?
- yes
- id
- ae9524e0-ace4-414d-a0e0-880006da7668
- date added to LUP
- 2020-11-12 17:57:27
- date last changed
- 2024-09-19 09:02:05
@article{ae9524e0-ace4-414d-a0e0-880006da7668, abstract = {{<p>INTRODUCTION: The pituitary gland has a high expression of somatostatin receptors (SSTRs) and is therefore a potential organ at risk for radiation-induced toxicity after 177Lu-DOTATATE treatment.</p><p>OBJECTIVE: To study changes in pituitary function in patients with neuroendocrine tumors (NETs) treated with dosimetry-based 177Lu-DOTATATE to detect possible late toxicity.</p><p>METHODS: 68 patients from a phase II clinical trial of dosimetry-based, individualized 177Lu-DOTATATE-therapy were included in this analysis. Patients had received a median of 5 (range 3-9) treatment cycles of 7.4 GBq/cycle. Median follow-up was 30 months (range 11-89). The GH/IGF1-axis, gonadotropins, adrenal and thyroid axes were analyzed from baseline and on a yearly basis thereafter. Percent changes in hormonal levels over time were analyzed statistically using a linear mixed model and described graphically using boxplots. The absorbed radiation dose to the pituitary was estimated based on post-therapeutic imaging, and the results analyzed vs % change in IGF1-levels over time.</p><p>RESULTS: A statistically significant decrease in the levels of IGF1 was found (p<0.005), which was correlated to the number of treatment cycles (p=0.008) and absorbed radiation dose (p=0.03). A similar decrease, although non-significant, was seen in the gonadotropins in post-menopausal women, while in men there was an increase during the first years post-therapy, after which the levels returned to baseline. No change was observed in the adrenal nor thyroid axes.</p><p>CONCLUSIONS: No signs of severe endocrine disorder were detected, although a significant decrease in the GH/IGF1-axis was found, where dosimetric analyses indicate radiation-induced damage to the pituitary gland as a probable cause.</p>}}, author = {{Sundlöv, Anna and Sjögreen-Gleisner, Katarina and Tennvall, Jan and Dahl, Ludvig and Svensson, Johanna and Åkesson, Anna and Bernhardt, Peter and Lindgren, Ola}}, issn = {{0028-3835}}, language = {{eng}}, pages = {{344--353}}, publisher = {{Karger}}, series = {{Neuroendocrinology}}, title = {{Pituitary function after high-dose 177Lu-DOTATATE therapy and long-term follow-up}}, url = {{http://dx.doi.org/10.1159/000507761}}, doi = {{10.1159/000507761}}, year = {{2021}}, }