Avaliação de Parâmetros Quantitativos Obtidos no PET/CT com DOTATOC-68GA na Predição de Resposta Terapêutica em Portadores de Neoplasia Neuroendócrina Metastática Submetidos a Tratamento com DOTA-OCTREOTATO-177Lu
Palavras-chave:
tumor neuroendócrino, Teranóstico, Lutécio 177, DOTATOC, PET/CTResumo
Fundamentos: A terapia radioisotópica com receptores de peptídeo utilizando DOTA-octreotato-177Lu constitui uma outra opção teranóstica (diagnóstica e terapêutica) para TNEs que expressam receptores de somatostatina. Quanto maior a expressão de tais receptores, maior a chance de sucesso com o tratamento. Existem formas de quantificar essa expressão através do PET/CT com DOTATOC-68Ga.
Objetivo: Determinar quais parâmetros do PET/CT-DOTATOC-68Ga possuem maior acurácia na predição de resposta à TRRP com DOTA-octreotato-177Lu.
Métodos: Estudo de coorte retrospectivo, observacional, baseado na análise individualizada por lesão categorizada a partir do banco de dados. Foram incluídas as lesões de pacientes portadores de tumor neuroendócrino metastático que receberam tratamento com DOTA-octreotato-177Lu, que possuíam exame de PET/CT DOTATOC-68Ga pré e pós-tratamento. Foram utilizados critérios de avaliação de resposta em tumores sólidos (RECIST) para avaliação de resposta e curvas ROC para identificar o melhor ponto de corte para os parâmetros quantitativos.
Resultados: Na predição de resposta à terapia com DOTA-TATE-177Lu, a variável ETRSL apresentou sensibilidade de 100%, especificidade de 82,6% e acurácia de 94,8% com ponto de corte em 65,6 (intervalo de confiança - IC 0,792-0,996 p=0,001). A variável SUVmax apresentou sensibilidade de 60%, especificidade de 100% e acurácia de 82,6% com ponto de corte em 36,9 (IC 0,636-0,942 p=0,009).
Conclusão: A ETRSL foi o parâmetro com maior acurácia na predição de resposta ao tratamento com DOTA-TATE-177Lu. Contudo, não houve significância estatística, possivelmente pelo tamanho reduzido da amostra. Mais estudos são necessários para confirmar tais achados.
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