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Somatostatin Receptor-Targeted Radioligand Therapy in Head and Neck Paraganglioma
Wolfgang Roll1, Michael Müther2, Peter B Sporns3
1Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.
Objective:
Surgical resection is the therapy of choice in head and neck paraganglioma but is associated with considerable morbidity. For treatment of inoperable or progressive disease, less aggressive adjuvant options are warranted. This study assessed effectiveness and safety of peptide receptor radionuclide therapy (PRRT) with lutetium-177-DOTATATE for head and neck paraganglioma with emphasis on response assessment.
Methods:
A retrospective analysis of 7 patients with head and neck paraganglioma treated with PPRT between May 2014 and October 2016 was performed. Three patients had jugulotympanic paraganglioma, 3 patients had carotid body tumors, and 1 patient had a combination of both. Patients underwent PRRT after discussion in the local tumor board regarding progressive disease, inoperability, or lack of other adjuvant options. All patients underwent 3-5 cycles of PRRT. Treatment response was evaluated by gallium-68-DOTATATE positron emission tomography/computed tomography and contrast-enhanced computed tomography or magnetic resonance imaging. Outcome measures were two-dimensional tumor diameters and total tumor volumes.
Results:
Median patient age was 60 years (interquartile range: 14-84 years). All patients had stable disease at posttherapy assessment. Decreasing tumor volumes were found in 4 patients. Clinical symptoms improved in 2 patients. No progression or adverse events occurred during a median follow-up of 39 months (interquartile range: 35-47 months).
Conclusions:
Somatostatin receptor-targeted therapy using lutetium-177-DOTATATE shows promising effectiveness with a high safety profile. Patients in whom surgical morbidity outweighs oncologic benefit should be informed about PRRT as a treatment option.
Insights
Peptide receptor radionuclide therapy (PRRT) with lutetium-177-DOTATATE offers a safe and effective treatment for head and neck paraganglioma. This therapy demonstrated stable disease and reduced tumor volume in most patients, with no adverse events.
Area of Science:
- Oncology
- Nuclear Medicine
Background:
- Head and neck paraganglioma treatment typically involves surgical resection, which carries significant morbidity.
- Less invasive adjuvant therapies are needed for inoperable or progressive head and neck paraganglioma cases.
Purpose of the Study:
- To evaluate the effectiveness and safety of peptide receptor radionuclide therapy (PRRT) using lutetium-177-DOTATATE for head and neck paraganglioma.
- To assess treatment response using imaging modalities and tumor volume changes.
Main Methods:
- Retrospective analysis of 7 head and neck paraganglioma patients treated with 3-5 cycles of PRRT.
- Tumor response assessed via Gallium-68-DOTATATE PET/CT and contrast-enhanced CT/MRI.
- Outcome measures included changes in tumor diameter and volume.
Main Results:
- All 7 patients achieved stable disease post-PRRT.
- Four patients showed decreasing tumor volumes.
- No disease progression or adverse events were observed during a median follow-up of 39 months.
Conclusions:
- Somatostatin receptor-targeted PRRT with lutetium-177-DOTATATE is a promising treatment for head and neck paraganglioma.
- PRRT exhibits a favorable safety profile and can be considered for patients where surgical morbidity is a concern.
