رسالة جامعية
Tailoring Radionuclide Therapy of Neuroendocrine Tumors - Bridging the Gaps
| العنوان: | Tailoring Radionuclide Therapy of Neuroendocrine Tumors - Bridging the Gaps |
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| المؤلفون: | Sundlöv, Anna |
| المصدر: | Lund University, Faculty of Medicine Doctoral Dissertation Series; (2020:15) (2020) ; ISSN: 1652-8220 |
| بيانات النشر: | Lund University, Faculty of Medicine |
| سنة النشر: | 2020 |
| المجموعة: | Lund University Publications (LUP) |
| مصطلحات موضوعية: | Cancer and Oncology, 177Lu-DOTATATE, PRRT, somatostatin analogs, pituitary function, renal function, dosimetry, 68Ga-DOTATATE, individualized treatment, neuroendocrine tumors |
| الوصف: | Background and Aims: Radionuclide therapy is systemic, targeted radiotherapy. As such, we can apply the basic principles of radiobiology used in everyday practice in radiation oncology, as a means of tailoring the treatment to each patient and optimizing the balance between efficacy and toxicity. The most common type of radionuclide therapy used for the treatment of neuroendocrine tumors, is 177Lu-DOTATATE. It has proven to be safe and effective, even without any tailoring. The aim of the work presented in this thesis is to systematically explore how we can further improve results for patients by tailoring the treatment. Methods and Results: The thesis is based on two clinical trials – Iluminet and Gapetto – which were both designed to address different aspects of the overall aim. The Iluminet trial is a phase II trial in which patients, instead of receiving the standard four cycles of 7.4 GBq of 177Lu-DOTATATE, are treated to the maximum number of cycles within the predefined limits for radiation dose to the kidneys. Safety and efficacy data are collected during treatment and follow-up. The Gapetto trial was a prospective observational study looking at the effect of somatostatin analog treatment on the uptake of 68Ga-DOTATATE in PET/CT. Papers I and II are based on the first 51 patients included in the Iluminet trial. Paper I presents data from an interim analysis of renal function, and also describes the effects that tailoring has on treatment planning. The mean number of treatment cycles the patients received was 5, but there were large interindividual variations. No serious renal toxicity was detected during the 24-month median follow-up. Paper II describes the consequences of simplifying the dosimetric protocol in order to make dosimetry more feasible in clinical practice. The results show that basing dosimetry on just one SPECT-image taken att 96h is as accurate as doing full hybrid dosimetry, which is the reference in the trial protocol. Paper III describes the pituitary function in 68 evaluable patients ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| وصف الملف: | application/pdf |
| اللغة: | English |
| ردمك: | 978-91-7619-875-9 91-7619-875-8 |
| العلاقة: | https://lup.lub.lu.se/record/3f6c20e5-7828-4d5e-a415-c5a283f1b2f1Test; urn:isbn:978-91-7619-875-9; https://portal.research.lu.se/files/72926776/Anna_Sundl_v_web.pdfTest |
| الإتاحة: | https://lup.lub.lu.se/record/3f6c20e5-7828-4d5e-a415-c5a283f1b2f1Test https://portal.research.lu.se/files/72926776/Anna_Sundl_v_web.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.83C75CEE |
| قاعدة البيانات: | BASE |
| ردمك: | 9789176198759 9176198758 |
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