Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE

Background: Lutetium-177 (177Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritone...

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Main Authors: Eleonora Pelle, Taymeyah Al-Toubah, Ghassan El-Haddad, Brian Morse, Bhavana Konda, Vineeth Sukrithan, Jonathan Strosberg
Format: Article
Language:English
Published: Bioscientifica 2025-07-01
Series:Endocrine Oncology
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Online Access:https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0033.xml
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author Eleonora Pelle
Taymeyah Al-Toubah
Ghassan El-Haddad
Brian Morse
Bhavana Konda
Vineeth Sukrithan
Jonathan Strosberg
author_facet Eleonora Pelle
Taymeyah Al-Toubah
Ghassan El-Haddad
Brian Morse
Bhavana Konda
Vineeth Sukrithan
Jonathan Strosberg
author_sort Eleonora Pelle
collection DOAJ
description Background: Lutetium-177 (177Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in 177Lu-DOTATATE-treated patients. Methods: Clinical records were reviewed of patients with midgut NETs treated with 177Lu-DOTATATE at the Moffitt Cancer Center between April 2018 and December 2022 and at The Ohio State University between December 2017 and October 2020. Results: Among the cases reviewed, we identified three patients who developed bowel ischemia/perforation shortly after their initial treatment with 177Lu-DOTATATE. All patients had metastatic small bowel NET with prominent mesenteric mass encasing/obstructing the mesenteric vessels and preexisting symptoms of postprandial abdominal pain. Conclusion: Acute bowel ischemia may be a rare complication of PRRT in patients with mesenteric arterial or venous obstruction from mesenteric metastasis.
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institution Kabale University
issn 2634-4793
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publishDate 2025-07-01
publisher Bioscientifica
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series Endocrine Oncology
spelling doaj-art-0f86869aee774c2aafeb65e895e99c3c2025-08-20T03:27:19ZengBioscientificaEndocrine Oncology2634-47932025-07-015110.1530/EO-25-00331Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATEEleonora Pelle0Taymeyah Al-Toubah1Ghassan El-Haddad2Brian Morse3Bhavana Konda4Vineeth Sukrithan5Jonathan Strosberg6Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USADepartment of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USADepartment of Diagnostic Imaging and Interventional Radiology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USADepartment of Diagnostic Imaging and Interventional Radiology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USADivision of Medical Oncology, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio, USADivision of Medical Oncology, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio, USADepartment of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USABackground: Lutetium-177 (177Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in 177Lu-DOTATATE-treated patients. Methods: Clinical records were reviewed of patients with midgut NETs treated with 177Lu-DOTATATE at the Moffitt Cancer Center between April 2018 and December 2022 and at The Ohio State University between December 2017 and October 2020. Results: Among the cases reviewed, we identified three patients who developed bowel ischemia/perforation shortly after their initial treatment with 177Lu-DOTATATE. All patients had metastatic small bowel NET with prominent mesenteric mass encasing/obstructing the mesenteric vessels and preexisting symptoms of postprandial abdominal pain. Conclusion: Acute bowel ischemia may be a rare complication of PRRT in patients with mesenteric arterial or venous obstruction from mesenteric metastasis.https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0033.xmlprrtbowel ischemiasmall bowel netmesenteric lesions
spellingShingle Eleonora Pelle
Taymeyah Al-Toubah
Ghassan El-Haddad
Brian Morse
Bhavana Konda
Vineeth Sukrithan
Jonathan Strosberg
Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE
Endocrine Oncology
prrt
bowel ischemia
small bowel net
mesenteric lesions
title Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE
title_full Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE
title_fullStr Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE
title_full_unstemmed Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE
title_short Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE
title_sort risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177lu dotatate
topic prrt
bowel ischemia
small bowel net
mesenteric lesions
url https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0033.xml
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