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Katarina Sjögreen Gleisner

Professor

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Pituitary function after high-dose 177Lu-DOTATATE therapy and long-term follow-up

Författare

  • Anna Sundlöv
  • Katarina Sjögreen-Gleisner
  • Jan Tennvall
  • Ludvig Dahl
  • Johanna Svensson
  • Anna Åkesson
  • Peter Bernhardt
  • Ola Lindgren

Summary, in English

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.

Avdelning/ar

  • Medicinsk onkologi
  • Nuclear Medicine Physics
  • Medicinsk strålningsfysik, Lund
  • Medicin, Lund

Publiceringsår

2021

Språk

Engelska

Sidor

344-353

Publikation/Tidskrift/Serie

Neuroendocrinology

Dokumenttyp

Artikel i tidskrift

Förlag

Karger

Ämne

  • Endocrinology and Diabetes
  • Other Physics Topics

Status

Published

Forskningsgrupp

  • Nuclear Medicine Physics

ISBN/ISSN/Övrigt

  • ISSN: 0028-3835