Nuklearmedizin 2021; 60(02): 99-105
DOI: 10.1055/a-1332-8230
Original Article

Cardiotoxicity and cardiac monitoring following the use of radiotheranostics agents including 177Lu-PSMA for prostate cancer and 177Lu-DOTATATE for neuroendocrine tumors

Kardiotoxizität und kardiale Überwachung nach dem Einsatz von Radiotheranostika einschließlich 177Lu-PSMA bei Prostatakrebs und 177Lu-DOTATATE bei neuroendokrinen Tumoren
Esmail Jafari
1   The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
,
Abdul Latif Amini
2   Bushehr Heart Medical center, Bushehr University of Medical Sciences, Bushehr, Iran
,
Hojjat Ahmadzadehfar
3   Department of Nuclear Medicine, Klinikum Westfalen, Dortmund, Germany
,
Dara Bagheri
4   Department of Fisheries, Faculty of Agriculture and Natural Resources, Persian Gulf University, Bushehr, Iran
,
Majid Assadi
1   The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
› Author Affiliations

Abstract

Background The aim of this study was to determine the probable cardiotoxicity following radionuclide therapy (RNT), specifically peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE and radioligand therapy (RLT) with 177Lu-PSMA by evaluation of serum troponin I and cardiac profile change during a follow-up time.

Materials and Methods Patients with prostate cancer and neuroendocrine tumours (NETs) referred for PRRT and RLT, respectively, were enrolled in this study. The cardiac profiles of the patients were evaluated by a cardiologist and a cardiac history was obtained from all patients. Also, troponin I was measured before and 48 hours after treatment.

Results In this retrospective study for assessment of RLT associated cardiotoxicity, 24 patients were evaluated with a median age of 64 years (27–99 years) including 13 NET patients and 11 prostate cancer patients. Patients were followed up for 4 to 31 months which no cardiovascular problem was observed. In evaluation of troponin I, 39 RNT cycles were evaluated. In all patients, the value of troponin I was in normal range. In all patients, the median values of serum troponin I before and after treatment were 0.2 ± 0.02 (range: 0.00–0.42) and 0.28 ± 0.02 (range: 0.00–0.46) ng/ml, respectively (p > 0.05). In the prostate cancer patients, the median values of serum troponin I before and after treatment were 0.26 ± 0.04 (0.04–0.42) and 0.30 ± 0.04 (0.00–0.41) ng/ml, respectively (p > 0.05). In the NET patients, the median values of serum troponin I before and after treatment were 0.18 ± 0.03 (0.00–0.42) and 0.17 ± 0.03 (0.00–0.46) ng/ml, respectively (p > 0.05).

Conclusion PRRT with 177Lu-DOTATATE and RLT with 177Lu-PSMA as emerging therapeutic modalities have no significant cardiotoxicity. However, further well-designed studies are recommended.

Zusammenfassung

Hintergrund Ziel dieser Studie war die Bestimmung der voraussichtlichen Kardiotoxizität nach Radionuklidtherapie (RNT), speziell der Peptidrezeptor-Radionuklidtherapie (PRRT) mit 177Lu-DOTATATE und der Radioligandentherapie (RLT) mit 177Lu-PSMA durch Bewertung von Serum-Troponin I und der kardialen Profilveränderung während einer Nachbeobachtungszeit.

Material und Methoden Patienten mit Prostatakrebs und neuroendokrinen Tumoren (NETs), die zur PRRT bzw. RLT überwiesen wurden, wurden in diese Studie eingeschlossen. Die kardialen Profile der Patienten wurden von einem Kardiologen beurteilt und von allen Patienten wurde eine kardiale Anamnese erhoben. Außerdem wurde Troponin I vor und 48 Stunden nach der Behandlung gemessen.

Ergebnisse In dieser retrospektiven Studie zur Beurteilung der RLT-assoziierten Kardiotoxizität wurden 24 Patienten mit einem medianen Alter von 64 Jahren (27–99 Jahre) untersucht, darunter 13 NET-Patienten und 11 Prostatakrebspatienten. Die Patienten wurden für 4–31 Monate nachbeobachtet, wobei keine Herz-Kreislauf-Probleme beobachtet wurden. Bei der Bewertung von Troponin I wurden 39 RNT-Zyklen ausgewertet. Bei allen Patienten lag der Wert von Troponin I im Normalbereich. Bei allen Patienten lagen die medianen Werte von Serum-Troponin I vor und nach der Behandlung bei 0,2 ± 0,02 (Bereich: 0,00–0,42) bzw. 0,28 ± 0,02 (Bereich: 0,00–0,46) ng/ml (p > 0,05). Bei den Prostatakrebspatienten betrugen die medianen Werte von Serum-Troponin I vor und nach der Behandlung 0,26 ± 0,04 (0,04–0,42) bzw. 0,30 ± 0,04 (0,00–0,41) ng/ml (p > 0,05). Bei den NET-Patienten betrugen die Medianwerte von Serum-Troponin I vor und nach der Behandlung 0,18 ± 0,03 (0,00–0,42) bzw. 0,17 ± 0,03 (0,00–0,46) ng/ml (p > 0,05).

Schlussfolgerung PRRT mit 177Lu-DOTATATE und RLT mit 177Lu-PSMA als neue therapeutische Modalitäten weisen keine signifikante Kardiotoxizität auf. Weitere gut konzipierte Studien werden jedoch empfohlen.



Publication History

Received: 20 September 2020

Accepted: 08 December 2020

Article published online:
18 January 2021

© 2021. Thieme. All rights reserved.

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