Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

The South Australian (177) Lu-DOTATATE peptide receptor radionuclide therapy service - a focus on quality of life outcomes in the treatment of somatostatin-receptor positive tumours (#517)

Liesl Altus 1 , Jake Forster 1 , Jessica Mercurio 1 , Nadia Corsini 2 , Marni Nenke 3 , Gabrielle Cehic 1 2
  1. The Queen Elizabeth Hospital Nuclear Medicine Department, Adelaide, South Australia, Australia
  2. University of South Australia, Adelaide, South Australia, Australia
  3. Endocrine Department, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia

Peptide receptor radionuclide therapy (PRRT) with [177Lu]-DOTA-octreotate (LuTate) has proven safety and efficacy in improving survival and health-related quality of life (hr-QOL) for patients with progressive metastatic neuroendocrine tumours (1-4). There is increasing recognition of its importance in treatment of other somatostatin receptor positive neoplasms including bronchial (5), paraganglioma and phaeochromocytoma (6).

Since the South Australian PRRT service started in 2011, hr-QOL (EORTC QLQ C30 +/- Gi NET21) questionnaires have been collected, along with demographic, clinical, pathological, and outcome data.  We present the QOL data from the first 11 years.  

Questionnaire results were scored per the EORTC manual and converted to 0-100 scales.  Paired surveys from the first cycle of an induction course of treatment and either the last completed cycle or the post treatment review were analysed.

There were 189 patients eligible for inclusion in the 11-year audit. Baseline characteristics tabulated below.

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Of the 822 total number of LUTATE cycles administered at TQEH during the audit period, 760 (92%) had a corresponding QOL questionnaire completed. Comparison of individual pre and post treatment scores from patients undergoing induction treatment is presented below, highlighting the marked heterogeneity in starting scores. Analysis of the overall mean change in scores showed multiple domains reaching statistical significance.

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Our service also uses QOL responses in real time to guide conversations about symptoms and potential interventions. In many cases, review of QOL scores with the patient was directly responsible for altered management including change in medications eg antidepressants, creon, increased analgesia; referrals for additional imaging or to other services eg dietetics, palliative care.

We have demonstrated that treatment with PRRT by our service resulted in significant improvement in QOL across multiple domains. We encourage routine use of patient-reported outcome measures in both daily clinical care and analysis of overall treatment outcomes.