RESUMO
BACKGROUND: PRRT can be an option for all-grade GEP-NETs, but selecting patients is challenging. In this scenario, clinical-pathological and radiological characteristics, such as pre-treatment Ga-68 DOTA PET/CT, might have the potential to help. METHODS: A retrospective chart review was conducted on advanced GEP-NETs treated with at least one PRRT dose. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Krenning Score (KS), and the maximum standardized uptake value (SUVmax) were derived from the pre-treatment scans. A maximally selected rank statistics test was used for SUVmax simple cut point estimate. RESULTS: Among 36 patients, 19 had primary pancreatic tumors. The numbers of G1, G2, and G3 tumors were 10, 18, and 7, respectively. During a median follow-up of 90.5 months, 4 patients died. Median OS was not reached for G1 and G2 tumors, and it was 30 months for G3 (p = 0.001). Median PFS was 23 months, with G3 showing lower PFS compared to G1 [7 versus 30 months; HR 8.41 (95%CI 2.2-31.0; p = 0.001)]. CONCLUSIONS: PRRT provides long-term PFS in patients with G1/G2 GEP-NETs independent of clinical characteristics and primary site. G3 has worse survival, but selected patients may experience long OS after PRRT treatment.
RESUMO
Objective: To make a review of studies that assessed the outcomes of GnRH agonist oocyte triggering in comparison with hCG in prevention of ovarian hyperstimulation syndrome and pregnancy rates. Methods: A systematic review of studies presented in the following database: PUBMED, Lilacs and Scielo submitted from January 2005 to October 2015. The keywords were ovulation induction, ovarian hyperstimulation syndrome and gonadotropin releasing hormone. Results: One hundred fifty-four articles were found. From these, twelve studies were completely analyzed. Eight fulfilled the inclusion criteria and one was included after the bibliographic review of the previous ones. From these nine submitted articles, two are retrospective and the others are prospective. Conclusion: The use of GnRH agonist for oocyte triggering was comparable with hCG and showed low frequency of ovarian hyperstimulation syndrome.(AU)
Objetivo: Fazer uma revisão dos estudos que avaliaram os desfechos do agonista de GnRH no ovócito em comparação com hCG na prevenção da síndrome de hiperestimulação ovariana e nas taxas de gestação. Métodos: Revisão sistemática de estudos presentes nos seguintes bancos de dados: Pubmed, Lilacs e Scielo, apresentados de janeiro de 2005 até outubro de 2015. As palavras-chave foram indução da ovulação, síndrome de hiperestimulação ovariana e hormônio liberador de gonadotropina. Resultados: Foram localizados 154 artigos; 12 foram integralmente analisados; oito preenchiam os critérios de inclusão; um foi incluído depois da revisão bibliográfica dos estudos precedentes. Dentre esses nove artigos apresentados, dois são retrospectivos e os demais são prospectivos. Conclusão: O uso do agonista de GnRH para a indução do ovócito foi comparável ao hCG, demonstrou baixa frequência de síndrome de hiperestimulação ovariana.(AU)