Introduction: Medullary thyroid carcinoma (MTC) represents about 3-16% of thyroid cancer. After first line treatment, therapeutic options for locally recurrent or metastasizing tumors include repeated surgery, whenever possible. Doxorubicin containing chemotherapy regimens in iodine-nonavid differentiated thyroid cancer have poor efficacy.
Aim(s): To evaluate toxicity and therapeutic efficacy (response and survival) of PRRT in radioiodine-nonavid/therapy refractory thyroid cancer patients.
Materials and methods: Fifteen iodine-nonavid/radioiodine therapy refractory thyroid cancer patients (mean age 60 yrs, M:F 7:8) were treated with PRRT using Y-90 and/or Lu-177 SMS analogs (DOTA-TATE/-TOC or -NOC). All patients were heavily pretreated and presented with progressive disease at follow-up. The dose range per cycle for Y-90 was 2500–5000 MBq, and 3500 – 7500 MBq for Lu-177. Primary histology: follicular cancer (n=4), medullary thyroid cancer (n=7), Hurthle cell carcinoma (n=3), and mixed carcinoma (n=1). Ga-68 somatostatin receptor PET/CT was used to determine the somatostatin receptor density in the metastastes and in recurrent tumor lesions and to assess treatment response. PRRT was performed under strict nephroprotection with amino acid infusions. Hematological profiles and renal function (GFR and TER) were regularly monitored after PRRT.
Conference: 7th Annual ENETS Conference (2010)
Presenting Author: Dr. Vikas Prasad
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