Summary (10 sec read)

PRRT (Peptide Receptor Radionuclide Therapy) is a targeted cancer treatment primarily for Neuroendocrine Tumors (NETs), involving four cycles of Lu177 DOTATATE administered approximately eight weeks apart. At Fortis Memorial Research Institute, Gurgaon, the procedure is often outpatient but may require brief hospitalization. The treatment begins with a patient consultation, medical review, and pre-treatment with anti-nausea medication and an amino acid solution to protect the kidneys. The entire process takes about 7-8 hours, concluding with a dosimetry molecular imaging scan to track the radio-peptide's distribution.

PRRT offers personalized treatment by tuning radio peptides (Lu177 or Y90) to tumor characteristics, delivering high doses of radiation directly to tumor cells while sparing healthy cells. It is effective for inoperable, metastatic, or progressive NETs, improving symptoms, halting tumor growth, and enhancing progression-free survival.

While generally well-tolerated, PRRT can have side effects such as nausea, vomiting, and long-term risks like blood count suppression, permanent renal toxicity, and Myelo Dysplastic Syndrome (MDS). Post-therapy guidelines emphasize maintaining good bathroom hygiene and following radiation safety protocols provided by Nuclear Medicine Physicians.

My last article (Which patients can benefit with PPRT?) summed up the fundamentals of Nuclear Medicine PRRT and which patients may benefit from this therapy. Today, I shall be giving you a low down on PRRT again, and we shall cover some details such as

  1. How is PRRT performed?
  2. What are the advantages of PRRT?
  3. Is PRRT safe?
  4. Post therapy guidelines?
How PRRT Performed?

The most common procedure followed during the PRRT process (as per US FDA and European Medicine Agency Approval) includes a series of 4 cycles of PRRT Treatments with Lu177 DOTATATE approximately 8 weeks apart. The treatment at our Nuclear Medicine Department at Fortis Memorial Research Institute, Gurgaon India can be done on an outpatient basis or may require hospitalisation of a few days. The Nuclear Medicine Physicians at our centre led by Dr. Ishita B Sen and Dr. Vineet Pant decide if a particular patient requires hospitalization or can be discharged the same day from the hospital.      

The procedure begins with a discussion with the Patient and the caregiver and proceeds with the patient's scan or review of the medical history and medical reports. The patient is then given appropriate anti-nausea pre-medicines followed by Amino acid solution. The amino acid solution is given intravenously to protect the Patient’s Kidneys from the effects of the treatment. The treatment in total last about 7-8 hours. The patient is then injected with the treatment followed by Amino Acid Solutions again.

Post the treatment a Dosimetry Molecular Imaging Scan is done to note where the injected radio-peptide has travelled in the patient’s body.

PRRT treatment advantages?

PRRT Treatment offers personalized cancer treatment, the radio peptides used (Lu 177 or Y 90) can be tuned to the tumour characteristics and the molecular property of the tumour cells.

PRRT is a selective therapy because the radio peptide cells bind themselves with the tumour cells directly and deliver a high dosage of radiation to kill tumour cells (Targeted Therapy). This also prevents damage to healthy cells in the body by limiting their exposure to radiation. PPRT has been found to be effective in inoperable or metastatic and progressive Neuroendocrine Tumours (NETs)

PRRT is well tolerated and is known to help relieve symptoms, arrest tumour growth, shrink tumour lesions, trials with PRRT have noted improved progression-free survival for the patients.

Is PRRT safe?

PRRT is generally well tolerated but like all other therapies it has its side effects and risks. Nuclear Physicians at our centre will take you through the details of the risks and side effects before the patient opts for this therapy

Side Effects of PRRT may include Nausea, vomiting, long term side effects include suppression of blood counts, permanent renal toxicity, Myelo Dysplastic Syndrome (MDS)

Post therapy guidelines?

Maintain good bathroom hygiene. Follow radiation safety protocols provided by highly skilled Nuclear Medicine Physicians at our centre. 

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