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The octreotide suppression test and [ 111 In‐DTPA‐D‐Phe 1 ]‐octreotide scintigraphy in neuroendocrine tumours correlate with responsiveness to somatostatin analogue treatment
Author(s) -
Weiming Shi,
K. D. Buchanan,
C.F. Johnston,
CJ Larkin,
Y. L. Ong,
R. Ferguson,
John E. Laird
Publication year - 1998
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.1998.00373.x
Subject(s) - octreotide , somatostatin , endocrinology , medicine , scintigraphy , nuclear medicine
OBJECTIVE The somatostatin analogue octreotide (Sandostatin, Novartis, Basle) significantly improves the syndromes suffered by most patients with neuroendocrine tumours (NETs). The use of [ 111 In‐DTPA‐D‐Phe 1 ]‐octreotide scintigraphy ([ 111 In]‐pentetreotide) to predict the response to octreotide treatment has been described. Short‐term hormone inhibition by a single injection of octreotide has also been reported. This study aimed to compare the effects of the suppression test with the response to long‐term somatostatin analogue treatment, and to seek a correlation between the short‐term suppression test, [ 11 In]‐pentetreotide observations and long‐term somatostatin analogue treatment. DESIGN AND MEASUREMENTS Short octreotide suppression test and octreotide scintigraphy. Blood samples were collected before (0900, 0930 h), at (1000 h), and after (1030, 1100, 1200, 1300 h) the injection of 50 μg octreotide subcutaneously. Plasma hormones relevant to the syndrome were analysed by radioimmunoassay. The short suppression effects, the [ 111 In]‐pentetreotide observations and the response to long‐term treatment with somatostatin analogue were evaluated and compared. PATIENTS Twenty‐six patients with metastatic NETs were evaluated, including 14 carcinoid tumours, 10 pancreatic endocrine tumours and 2 medullary carcinomas of thyroid (MCTs). Twelve patients had received octreotide treatment before the study, another 4 patients were treated subsequently with somatostatin analogue. RESULTS During the short suppression test, hormones relevant to the syndromes were suppressed in 24 patients (those with carcinoids and pancreatic endocrine tumours). There was no suppression in the 2 patients with MCT. [ 111 In]‐pentetreotide observations closely correlated with the short suppression response to octreotide. Fourteen patients were treated with somatostatin analogue, and responded clinically; they had a positive short inhibition test and positive tumour uptake. Two patients with MCT did not respond to the treatment and had a negative suppression test and a negative [ 111 In]‐pentetreotide. CONCLUSION Our results suggest that a consistent relationship exists between the short suppression test and the response to somatostatin analogue treatment in the majority of the patients with neuroendocrine tumours. The octreotide suppression test and octreotide scintigraphy together will be helpful in selecting appropriate patients for clinical treatment with somatostatin analogues.