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Baseline and follow-up <jats:sup>68<\/jats:sup>Ga-DOTATOC PET\/CT, lab tests, and renal scintigraphy were obtained. Patients received long-term follow-up either at the local cancer center or in close collaboration with external oncologists. Acute and chronic hematological toxicity was evaluated quantitatively over time. Long-term follow-up of creatinine was used to approximate the annual loss of estimated GFR (eGFR).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Dose-dependent acute hematological toxicity was seen at single doses above 40 MBq or repeated doses greater than approximately 20 MBq <jats:sup>225<\/jats:sup>Ac-DOTATOC at 4 month intervals. Treatment-related kidney failure occurred in 2 patients after a delay of &gt;4 years but was independent of administered radioactivity, and other clinical risk factors were important contributors to renal decline. In general, the annual decline of eGFR among patients did not follow a clear dose-effect relationship even in patients with previous \u03b2-therapy. An average eGFR-loss of 8.4ml\/min (9.9%) per year was observed which is similar to the experience with \u03b2-therapy studies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Treatment activities of approx. 20 MBq per cycle (4 monthly repetition) and cumulative doses up to 60\u201380 MBq generally avoided both acute and chronic grade 3\/4 hematotoxicity in patients with advanced stage malignancies. Chronic renal toxicity was observed at these doses, but pre-existing renal risk factors were important co-factors. These data represent a starting point for additional research to more precisely define safety thresholds of <jats:sup>225<\/jats:sup>Ac-DOTATOC.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-021-05474-1","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T21:02:39Z","timestamp":1630011759000},"page":"54-63","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["Dosing 225Ac-DOTATOC in patients with somatostatin-receptor-positive solid tumors: 5-year follow-up of hematological and renal toxicity"],"prefix":"10.1007","volume":"49","author":[{"given":"Clemens","family":"Kratochwil","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas","family":"Apostolidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Rathke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Apostolidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Bicu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Bruchertseifer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter L","family":"Choyke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Haberkorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik L","family":"Giesel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Morgenstern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"issue":"2","key":"5474_CR1","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1002\/cncr.25425","volume":"117","author":"JR Strosberg","year":"2011","unstructured":"Strosberg JR, Fine RL, Choi J, Nasir A, Coppola D, Chen DT, et al. 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No registration is needed for this kind of study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial registration"}}]}}