Peptide receptor radionuclide therapy in head and neck paragangliomas – Report of 14 cases.

Background: Peptide receptor radionuclide therapy (PRRT) is a very promising treatment option in neuroendocrine tumours, with good results, but there are only few reports regar­ding its use in paragangliomas. Methods: The authors conduc­ted a retrospective study during the period of May 2011 to February 2014 in an Oncological Centre. Ten patients with jugular-tympanic paragangliomas and four with carotid body paragangliomas were treated with three cycles of Lutetium labelled peptide (177 Lu-DOTATATE). Treatment response was assessed with a PET-CT with 68 Ga-DOTANOC and clinical crite­ria. Results: Ten of the fourteen patients showed a decrea­se in the tumor standard uptake value (SUV) after treat­ment. 90% of patients with Jugulotympanic paraganglio­mas had symptomatic improvement or stabilization. Patients with carotid body paragangliomas and patients with a low uptake of 68 Ga-DOTANOC had a worse response to the treatment. The tumor SUV value was a predictor of treatment response [R= 0,64; F= 8,212; p= 0,014]. Conclusion: Peptide receptor radio­nuclide therapy can be a therapeutic option in selected cases of head and neck paragangliomas.