Quality of life in 265 patients with gastroenteropancreatic or bronchial neuroendocrine tumors treated with [177Lu-DOTA0,Tyr3]octreotate.

Abstract

UNLABELLED:

Quality of life (QOL) is an important outcome in cancer therapy. In this study, we investigated the QOL and symptoms after [(177)Lu-DOTA(0),Tyr(3)]octreotate ((177)Lu-octreotate) therapy in patients with inoperable or metastasized gastroenteropancreatic or bronchial neuroendocrine tumors (NETs).

METHODS:

Two hundred sixty-five Dutch patients completed the QOL questionnaire of the European Organization for the Research and Treatment of Cancer after being treated for NETs. ANOVA was used for statistical analyses, with a P value of 0.05 or less being considered significant. Differences of at least 10 points in global health status (GHS)/QOL scores, symptom scores, and Karnofsky performance scores (KPS) before and after therapy were regarded as indicating an improvement.

RESULTS:

Regardless of the treatment outcome, GHS/QOL, insomnia, appetite loss, and diarrhea improved significantly in the total group. These improvements were also seen in patients with bone metastases or a decrease of 50% or more in chromogranin A. Improvement in the scores by at least 10 points was also analyzed in a subgroup of patients with decreased GHS/QOL or symptoms at the start of therapy: in 36% of these patients, GHS/QOL improved after therapy; in 49%, fatigue; in 70%, nausea plus vomiting; in 53%, pain; in 44%, dyspnea; in 59%, insomnia; in 63%, appetite loss; in 60%, constipation; and in 67%, diarrhea. Additionally, we did not see a statistically significant deterioration in patients who had GHS/QOL 100, KPS 100, or no symptoms at the start. In patients with initial stable disease or remission after treatment, GHS/QOL and KPS decreased significantly when regrowth of the tumors occurred.

CONCLUSION:

GHS/QOL, KPS, and symptoms improved significantly after (177)Lu-octreotate therapy, and there was no significant decrease in QOL in patients who had no symptoms before therapy. In patients who had suboptimal scores for GHS/QOL or symptoms before therapy, a clinically significant improvement was demonstrated. Our results indicate that (177)Lu-octreotate therapy not only reduces tumors and prolongs overall survival but also improves the patients' self-assessed QOL.

• Authors: Saima Khan, Eric P Krenning, Martijn van Essen, Boen L Kam, Jaap J Teunissen, Dik J Kwekkeboom
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 52 Issue 9 Pg. 1361-8 (Sep 2011) ISSN: 1535-5667 [Electronic] United States
• PMID: 21795361 (Publication Type: Journal Article)

Chemical References

• Organometallic Compounds
• Radiopharmaceuticals
• lutetium Lu 177 dotatate
• Octreotide

Topics

• Anorexia (psychology)
• Data Interpretation, Statistical
• Disease Progression
• Emotions (physiology)
• Female
• Health Status
• Humans
• Karnofsky Performance Status
• Male
• Neoplasm Metastasis (radiotherapy)
• Neuroendocrine Tumors (psychology, radiotherapy)
• Octreotide (adverse effects, analogs & derivatives, therapeutic use)
• Organometallic Compounds (adverse effects, therapeutic use)
• Pain (epidemiology, psychology)
• Pancreatic Neoplasms (psychology, radiotherapy)
• Quality of Life (psychology)
• Radiopharmaceuticals (adverse effects, therapeutic use)
• Social Behavior
• Stomach Neoplasms (psychology, radiotherapy)
• Surveys and Questionnaires
• Treatment Outcome