Somatostatin receptor scintigraphy in advanced renal cell carcinoma

L. S. Freudenberg; T. Gauler; R. Görges; S. Bauer; H. Stergar; G. Antoch; A. Bockisch; J. Schütte

doi:10.3413/nukmed-0119

Nuklearmedizin - NuclearMedicine, Inhaltsverzeichnis

Nuklearmedizin 2008; 47(03): 127-131
DOI: 10.3413/nukmed-0119

Originalarbeiten - Original Articles

Schattauer GmbH

Somatostatin receptor scintigraphy in advanced renal cell carcinoma

Results of a phase II-trial of somatostatine analogue therapy in patients with advanced RCCSomatostatinrezeptor-Szintigraphie bei fortgeschrittenem NierenzellkarzinomErgebnisse der Phase-IISomatostatinanalogtherapie bei Patienten mit fortgeschrittenem Nierenzellkarzinom

L. S. Freudenberg

¹Department of Nuclear Medicine (Director: Prof. Dr. med. Dr. rer. nat. A. Bockisch)

,

T. Gauler

²Department of Internal Medicine (Cancer Research) (Director: Prof. Dr. med. Seeber)

,

R. Görges

¹Department of Nuclear Medicine (Director: Prof. Dr. med. Dr. rer. nat. A. Bockisch)

,

S. Bauer

²Department of Internal Medicine (Cancer Research) (Director: Prof. Dr. med. Seeber)

,

H. Stergar

¹Department of Nuclear Medicine (Director: Prof. Dr. med. Dr. rer. nat. A. Bockisch)

,

G. Antoch

³Department of Diagnostic and Interventional Radiology and Neuroradiology (Director: Prof. Dr. med. M. Forsting), University of Duisburg-Essen

,

A. Bockisch

¹Department of Nuclear Medicine (Director: Prof. Dr. med. Dr. rer. nat. A. Bockisch)

,

J. Schütte

⁴Department of Medical Oncology/Hematology (Director: Prof. Dr. med. J. Schütte), Marien-Hospital Düsseldorf, Germany

› Institutsangaben

Abstract

Summary

Aims: Objective of this prospective study was to evaluate the role of somatostatin receptor scintigraphy (SRS) in advanced renal cell carcinoma (RCC) with respect to potential therapy with somatostatin analogue (SST-A) and to assess the response rate under therapy with SST-A. Patients, methods: 16 patients with documented progression of histologically confirmed advanced RCC were included. Planar whole-body SRS was performed 4, 24 and 48h post i.v. injection of 175–200 MBq 111In-pentetreoide. 5 and 25 h p.i. SPECT of thorax and abdomen were performed. Documentation of somatostatin receptor expression via SRS in >50% of known tumour lesions was the criteria for treatment start with SST-A (Sandostatin LAR®-Depot 30mg i.m. every four weeks). Results: In 9/16 of the patients SRS showed at least one metastasis with moderate (n = 5) or intense (n = 4) tracer uptake. Lesion-based SRS evaluation showed only 12.1% (20/165) of all metastases. Most false-negative lesions were located in the lungs. In two patients, the majority of the known metastases was SRS positive and these patients received SST-A therapy. The first radiographic evaluation after a twomonth interval showed progressive disease in both patients. Conclusions: We conclude that SRS is of limited value in staging of advanced RCC. In our patients SST-A did not result in a growth control of RCC. Consequently, the use of SST-A in advanced RCC seems to be no relevant therapeutic option.

Zusammenfassung

Ziel: Diese prospektive Studie untersucht die Rolle der Somatostatinrezeptor- Szintigraphie (SRS) bei Patienten mit fortgeschrittenen Nierenzellkarzinomen (RCC) im Hinblick auf eine mögliche Therapie mit Somatostatinanaloga (SST-A) und deren Response-Rate. Patienten, Methoden: 16 Patienten mit dokumentiertem Progress eines histologisch gesicherten RCC wurden eingeschlossen. Die planare Ganzkörper-SRS erfolgte 4, 24 und 48 h nach i.v.-Injektion von 175–200 MBq 111In-Pentetreoid. Fünf und 25 h p.i. wurde je eine SPECT von Thorax und Abdomen akquiriert. Bei einer Somatostatinrezeptor-Expression via SRS in >50% der bekannten Tumorläsionen wurde eine Therapie mit SST-A (Sandostatin LAR®-Depot 30mg i.m. alle vier Wochen) begonnen. Ergebnisse: In 9/16 der Patienten zeigte die SRS mindestens eine Metastase mit moderater (n = 5) oder intensiver (n = 4) Traceranreicherung. In der läsionsbasierten Auswertung zeigten sich jedoch nur 12,1% (20/165) der Metastasen. Die meisten falsch-negativen Läsionen fanden sich in der Lunge. Zwei Patienten, bei denen die Mehrzahl der Metastasen SRS-positiv waren, erhielten eine Therapie mit SST-A. Die erste radiologische Kontrolle nach zwei Monaten zeigte einen Progress der Erkrankung in beiden Patienten. Schlussfolgerung: Die SRS ist im Restaging von Patienten mit fortgeschrittenem RCC nur von begrenztem Wert. In unseren Patienten konnte mit SST-A kein Effekt auf das Größenwachstum der RCC erreicht werden. Dementsprechend scheint SST-A bei fortgeschrittenem RCC keine relevante therapeutische Option zu sein.

Keywords

Somatostatin receptor scintigraphy - renal cell carcinoma - somatostatin analogue - phase-II-trial

Schlüsselwörter

Somatostatinrezeptor-Szintigraphie - Nierenzellkarzinom - Somatostatin-Analoga - Phase-II-Trial

Volltext

Referenzen

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