gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Somatostatin receptor targeted radioligand therapy in head and neck paraganglioma

Somatostationrezeptor-Radiotherapie für Kopf-/Hals-Paragangliome

Meeting Abstract

  • presenting/speaker Michael Müther - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Wolfgang Roll - Universitätsklinikum Münster, Klinik für Nuklearmedizin, Münster, Deutschland
  • Bastian Zinnhardt - Universitätsklinikum Münster, Klinik für Nuklearmedizin, Münster, Deutschland
  • Eric Suero Molina - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Michael Schäfers - Universitätsklinikum Münster, Klinik für Nuklearmedizin, Münster, Deutschland
  • Matthias Weckesser - Universitätsklinikum Münster, Klinik für Nuklearmedizin, Münster, Deutschland
  • Kambiz Rahbar - Universitätsklinikum Münster, Klinik für Nuklearmedizin, Münster, Deutschland
  • Walter Stummer - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP171

doi: 10.3205/20dgnc454, urn:nbn:de:0183-20dgnc4547

Veröffentlicht: 26. Juni 2020

© 2020 Müther et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Surgical resection is the therapy of choice in head and neck paraganglioma (HNPGL), however associated with significant morbidity depending on tumor size and localization. In cases of progressive residual or recurrent disease, novel and less aggressive therapeutic options are warranted. Somatostatin receptor (SSTR) targeted radioligand therapy poses a promising alternative, as SSTRs are upregulated in paraganglioma. However, only few studies provide evidence on indications, safety and effectiveness. The aim of this study was to provide a case series on peptide receptor radionuclide therapy (PPRT) with 177Lu-DOTATATE for HNPGL in a single center setting.

Methods: Restrospective case series on all PRRT with 177Lu-DOTATATE for HNPG from 2015 to 2019; protocol according to PRRT guidelines established for neuroendocrine tumors. Therapy response was assessed by pre- and three-month post-therapy 68Ga-DOTATATE-PET-CT (threshold set at 41% SUVpeak) and MRI volumetric analysis. Therapeutic uptake was classified on 177Lu-DOTATATE scintigraphies 48h p.i. according to the Krenning scale. Longer-term clinical outcome and MRI follow-ups were evaluated.

Results: A total number of seven patients (mean age 60 years; range 14 - 84) with HNPGL (3 carotid body tumors, 4 jugulotympanic paragangliomas) were included in this retrospective analysis. Patients received a median of 4 cycles (IQR 3 - 5) of 177Lu-DOTATATE PRRT. Comparison of pre- and post-therapy imaging showed an increase in PET volumes only in one patient; technical reasons did not allow for a meaningful comparison with MRI in this patient. Tumor uptake in 48h p.i. 177Lu-scintigraphies was moderate to high in all patients (median Krenning scale 3, IQR 2-4). None of the patients showed progressive disease during a median follow-up time of 28 months. Symptoms improved in 2/7 patients. Sensineural hearing loss is the symptom less likely to improve after PRRT. No adverse events were noted.

Conclusion: SSTR-targeted therapy using 177Lu-DOTATATE shows promising effectiveness for growth stabilization at high safety profile. Quantitative 68Ga-DOTATATE-PET complements morphological standard MRI / CT skull base imaging, especially in cases of previous sugery or irradiation.