PURPOSE AND METHODS: Patients with inoperable andmetastasized neuroendocrine tumors (NETs), particularly those with grades 1 and 2, usually receive treatment with somatostatin analogues (SSAs). Peptide receptor radionuclide therapy (PRRT) has gained momentum over the past two decades in patients who progress on SSAs. 177Lu-DOTATATE is currently the most widely used radiopeptide for PRRT. We reviewed the recent evidence on PRRT and the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs).RESULTS: ¹⁷⁷Lu-DOTATATE can be used as neoadjuvant treatment in patients with inoperable GEP-NETs, who might be candidate for surgery after treatment and as adjuvant therapy after surgical intervention. Combination treatments of PRRT with chemotherapy or targeted agents as well as combinations of radionuclides in patients with NETs have been explored over the last few years. The majority of patients with NETs experience partial response or have disease stabilization, a small percentage has complete response, while some 30% of patients, however, will have disease progression. The safety and efficacy of retreatment with extra cycles of PRRT as salvage therapy have been evaluated in small retrospective series.CONCLUSION: Overall, there is evidence that disease control and quality of life improve significantly after 117Lu PRRT therapy. Clinical trials on this therapy are scarce, and there is a need for further studies to establish proper management guidelines.
Disease Progression ; Drug Therapy ; Humans ; Lutetium ; Neoadjuvant Therapy ; Neuroendocrine Tumors ; Nuclear Medicine ; Quality of Life ; Radioisotopes ; Receptors, Peptide ; Retreatment ; Retrospective Studies ; Salvage Therapy ; Somatostatin ; Theranostic Nanomedicine

PURPOSE: AND METHODS: Patients with inoperable andmetastasized neuroendocrine tumors (NETs), particularly those with grades 1 and 2, usually receive treatment with somatostatin analogues (SSAs). Peptide receptor radionuclide therapy (PRRT) has gained momentum over the past two decades in patients who progress on SSAs. 177Lu-DOTATATE is currently the most widely used radiopeptide for PRRT. We reviewed the recent evidence on PRRT and the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs). RESULTS: ¹⁷⁷Lu-DOTATATE can be used as neoadjuvant treatment in patients with inoperable GEP-NETs, who might be candidate for surgery after treatment and as adjuvant therapy after surgical intervention. Combination treatments of PRRT with chemotherapy or targeted agents as well as combinations of radionuclides in patients with NETs have been explored over the last few years. The majority of patients with NETs experience partial response or have disease stabilization, a small percentage has complete response, while some 30% of patients, however, will have disease progression. The safety and efficacy of retreatment with extra cycles of PRRT as salvage therapy have been evaluated in small retrospective series. CONCLUSION Overall, there is evidence that disease control and quality of life improve significantly after 117Lu PRRT therapy. Clinical trials on this therapy are scarce, and there is a need for further studies to establish proper management guidelines.

Non-ossifying fibroma (NOF) is a common benign bone tumor with a high probability of occurrence in children and adolescents.It is commonly seen in the metaphysis of long bones, eccentrically located, and can coexist with other malignant tumors such asneuroendocrine tumors (NET). To date, plain radiographs play a major role in the diagnosis of these benign bone tumors. Herein,we report the case of a 13-year-old male patient who was diagnosed with pulmonary NET and underwent right lung lobectomyfor a hilar mass which later revealed a well-differentiated NET. The follow-up 68Ga DOTA-TOC PET/CT showed a focalsomatostatin receptor expression in the left distal femur, with corresponding CT component findings of a well-defined osteolyticbone lesion located within the medial aspect of the left distal femoral metaphysis, strongly indicative of NOF. To the best of ourknowledge, this is the first reported case of such an occurrence.