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Quality of life in patients with midgut NET following peptide receptor radionuclide therapy

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Objectives

There is convincing evidence that peptide receptor radionuclide therapy (PRRT) using 177Lu-DOTATATE compared to octreotide therapy has a positive effect on overall survival and progression-free survival in midgut neuroendocrine tumors (NET). The current study analyzed health-related quality of life (QoL) in patients undergoing PRRT with a special focus on differences in functional performance.

Materials and methods

In our study, 70 patients (39 men or 31 female) suffering from midgut NET were included, with a mean age of 64.2 years. Functional performance was assessed by the index of the Eastern Cooperative of Oncology Group (ECOG). Thirty-three patients (47%) showed ECOG 0, 31 patients (44%) ECOG 1, and six patients (9%) ECOG 2. Health-related QoL was assessed by the EORTC QLQ-C30 questionnaire filled in at baseline and 3 months after each PRRT cycle.

Results

The median cumulative administered activity was 27.4 GBq. Global health status significantly improved compared to baseline status after 1st (p = 0.05), 2nd (p = 0.004), and 3rd (p = 0.04) treatment cycle. Analyzing specific aspects of QoL, emotional functioning significantly improved after 1st and 2nd treatment cycle (both p < 0.001) as well as after 3rd cycle (p = 0.001). With regard to cognitive functioning, there was a significant improvement after 1st and 2nd treatment cycle (p = 0.003 and p = 0.05 respectively). With regard to alleviation of somatic symptoms, a significant reduction in pain and diarrhea was observed after the 2nd cycle (p = 0.038) and 3rd cycle (p = 0.036). Furthermore, changes in QoL in relation to functional performance status as assessed by ECOG were analyzed. There were no significant differences with regard to QoL alterations between patients with high (ECOG 0 or 1) and moderate performance status.

Conclusion

Our study confirmed an equally positive effect of PRRT on quality of life in midgut NET patients with high or moderate functional status in terms of increasing global health, functional status, and alleviating symptoms.

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Authors and Affiliations

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

    Milka Marinova & Shiwa Ghaei

  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, Sigmund-Freud-Str. 25, 53127, Bonn, Germany

    Felix Fischer, Markus Essler & Hojjat Ahmadzadehfar

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

    Rupert Conrad

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  1. Milka Marinova
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Correspondence to Hojjat Ahmadzadehfar.

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Conflict of interest

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

Ethical approval

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.

Informed consent

All participants signed informed consent for the PRRT treatment. Retrospective analysis was performed according to institutional ethical guidelines, and the requirement for separate informed consent for this analysis was waived.

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

This article is part of the Topical Collection on Oncology — Digestive tract

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Marinova, M., Mücke, M., Fischer, F. et al. Quality of life in patients with midgut NET following peptide receptor radionuclide therapy. Eur J Nucl Med Mol Imaging 46, 2252–2259 (2019). https://doi.org/10.1007/s00259-019-04431-3

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