Metabolic radiotherapy of neuroendocrine tumors using DOTATATE labeled with lutetium 177: Lebanese experience about 6 cases with review of the literature

The prevalence of neuroendocrine tumors (NET) is rare. Although some aggressive forms may exist, most NET shows a slow growth. The diagnosis is frequently made at a metastatic stage with more than 50% of hepatic metastasis. The only curative treatment is radical surgery and the other non-surgical therapeutic choices are chemotherapy, hepatic chemoembolization, alpha interferon, cold or non-radioactive somatostatin analogues and, more recently introduced, metabolic or internal radiotherapy with a somatostatin analogue coupled to an appropriate radioisotope. Nowadays, imagining of NET with a ⁶⁸Ga-DOTATATE PET allows obtaining a better image quality and an effective dosimetry before treating with a somatostatin analogue coupled to an appropriate radioisotope such as ¹⁷⁷Lu-DOTATATE. This latter can stabilize a rapidly progressive disease and improve quality of life enough and change it deeply. We are presenting our Lebanese experience by reporting six cases treated with ¹⁷⁷Lu- DOTATATE after a PET/CT ⁶⁸Ga-DOTATATE, and a review of literature. (authors)