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Improving quality of life in patients with pancreatic neuroendocrine tumor following peptide receptor radionuclide therapy assessed by EORTC QLQ-C30

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Abstract

Introduction

Neuroendocrine tumors (NETs) have proven to be appropriate neoplasms for peptide receptor radionuclide therapy (PRRT), as the majority of these slow-growing malignancies overexpress somatostatin receptors. The aim of this study was to evaluate changes in quality of life (QoL) of patients with P-NET following PRRT.

Methods

Sixty-eight patients with P-NET (31 female, mean age 61.4 y) underwent PRRT: 12 with NET of grade 1, 40 of grade 2, 8 of grade 3 (grade non-available n = 8). Prior to treatment, 39 patients showed ECOG 0, 26 patients ECOG 1, and three patients ECOG 2. Clinical assessment included evaluation of QoL and symptom changes using a standardized questionnaire (EORTC QLQ-C30) and was performed at baseline and every three months following each therapy cycle up to 12 months. Primary analysis compared QoL at baseline and after the fourth treatment cycle (N = 53).

Results

Up to four treatment cycles PRRT were performed for each patient. The median cumulative administered activity was 28.2 GBq. Primary analysis revealed that compared to baseline QoL was significantly improved revealing increased global health status (p = 0.008) and social functioning (p = 0.049) at the end of the study. Furthermore, fatigue and appetite loss showed a significant improvement after the last PRRT cycle (fatigue: p = 0.029, appetite loss p = 0.015). Sub-analyses showed that QoL was improved revealing increased global health status (3 months after first, second, and third treatment cycle p = 0.048, p = 0.002, and p < 0.001, respectively), emotional functioning (3 months after first-third cycle p = 0.003, p = 0.049, and p = 0.001, respectively) and social functioning (3 months after the first and second p < 0.001, and after the third cycle p = 0.015, respectively). Furthermore, some symptoms were significantly alleviated compared with baseline: fatigue (after first-third cycle p = 0.026, p = 0.050, and p = 0.008, respectively), nausea and vomiting (after first and second cycle p = 0.006 and p = 0.001, respectively), dyspnea (after third cycle p = 0.025), appetite loss (after first-third cycle p = 0.010, p = 0.001, and p = 0.009, respectively), constipation (after first-third cycle p = 0.050, p = 0.003, and p = 0.060, respectively).

Conclusion

PRRT is an effective treatment of P-NET improving QoL of patients in terms of increasing global health and mitigation of physical complaints.

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Acknowledgements

The authors acknowledge Guido Lüchters who provided valuable support and advice in all statistical questions at any time.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Bonn, Bonn, Germany

    Milka Marinova

  2. Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany

    Martin Mücke, Henning Cuhls & Lukas Radbruch

  3. Department of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany

    Martin Mücke

  4. Center for Rare Diseases Bonn (ZSEB), University Hospital of Bonn, Bonn, Germany

    Martin Mücke

  5. Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany

    Lukas Mahlberg, Markus Essler & Hojjat Ahmadzadehfar

  6. Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Bonn, Bonn, Germany

    Rupert Conrad

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Correspondence to Hojjat Ahmadzadehfar.

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The authors declare that they have no financial or non-financial competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Milka Marinova and Martin Mücke shared first authorship, Rupert Conrad and Hojjat Ahmadzadehfar shared senior authorship.

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Marinova, M., Mücke, M., Mahlberg, L. et al. Improving quality of life in patients with pancreatic neuroendocrine tumor following peptide receptor radionuclide therapy assessed by EORTC QLQ-C30. Eur J Nucl Med Mol Imaging 45, 38–46 (2018). https://doi.org/10.1007/s00259-017-3816-z

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