{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:27:41Z","timestamp":1793291261884,"version":"4.5.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Jpn J Radiol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>To investigate the clinical features of patients with neuroendocrine tumors (NETs) who could not complete the standard protocol (4 cycles of 7.4\u00a0GBq per 8\u00a0weeks) <jats:sup>177<\/jats:sup>Lu-DOTATATE treatment<jats:bold>.<\/jats:bold>\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>A retrospective single-center analysis was conducted on 26 patients who underwent <jats:sup>177<\/jats:sup>Lu-DOTATATE treatment between December 2021 and August 2024. Therapeutic outcome was compared with clinical features, including location and number of metastatic lesions, interval from diagnosis to the first <jats:sup>177<\/jats:sup>Lu-DOTATATE treatment, and laboratory data. Statistical analyses were performed to identify clinical features associated with dose reduction or treatment discontinuation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The clinical data of 24 patients with metastatic neuroendocrine tumors (NETs) were analyzed, of whom 16 patients completed the standard protocol <jats:sup>177<\/jats:sup>Lu-DOTATATE treatment. The most common adverse events were hematologic toxicities. Eight patients did not complete the standard protocol treatment, primarily due to adverse events (6\/8). Single variable logistic regression analysis revealed that the presence of somatostatin receptor scintigraphy (SRS) positive bone metastases (OR\u2009=\u200921.0, 95% CI 2.37\u2013186, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) and lower hemoglobin levels (OR\u2009=\u20090.479, 95% CI 0.255\u20130.900, <jats:italic>p<\/jats:italic>\u2009=\u20090.022) were significantly associated with incomplete treatment. Notably, 5\/8 patients in the incomplete group had extensive bone metastases (&gt;\u200920 lesions), including 4 with diffuse metastases. Other variables, including age, sex, white blood cell count, platelet count, eGFR, and other metastatic sites, showed no significant association with treatment completion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In this study, the presence of SRS-positive bone metastases and low hemoglobin levels were significant factors associated with the inability to complete <jats:sup>177<\/jats:sup>Lu-DOTATATE treatment for NET patients. Extensive bone metastases, such as diffuse metastasis or more than 20 bone metastases, may be particularly associated with the inability to administer standard protocol treatment.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11604-025-01769-7","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T22:08:51Z","timestamp":1744063731000},"page":"1372-1379","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of clinical factors associated with incomplete standard protocol 177Lu-DOTATATE treatment in neuroendocrine tumor patients"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8795-8099","authenticated-orcid":false,"given":"Shigeyasu","family":"Sugawara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shozo","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Go","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tohru","family":"Shiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noboru","family":"Oriuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"issue":"2","key":"1769_CR1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1056\/NEJMoa1607427","volume":"376","author":"J Strosberg","year":"2017","unstructured":"Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, et al. Phase 3 trial of 177Lu-Dotatate for midgut neuroendocrine tumors. N Engl J Med. 2017;376(2):125\u201335.","journal-title":"N Engl J Med"},{"issue":"12","key":"1769_CR2","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1016\/S1470-2045(21)00572-6","volume":"22","author":"JR Strosberg","year":"2021","unstructured":"Strosberg JR, Caplin ME, Kunz PL, Ruszniewski PB, Bodei L, Hendifar A, et al. 177Lu-Dotatate plus long-acting octreotide versus high-dose long-acting octreotide in patients with midgut neuroendocrine tumours (NETTER-1): final overall survival and long-term safety results from an open-label, randomised, controlled, phase 3 trial. Lancet Oncol. 2021;22(12):1752\u201363.","journal-title":"Lancet Oncol"},{"issue":"11","key":"1769_CR3","doi-asserted-by":"publisher","first-page":"3830","DOI":"10.1007\/s00259-022-05786-w","volume":"49","author":"A Sundl\u00f6v","year":"2022","unstructured":"Sundl\u00f6v A, Gleisner KS, Tennvall J, Ljungberg M, Warfvinge CF, Holgersson K, et al. Phase II trial demonstrates the efficacy and safety of individualized, dosimetry-based 177Lu-DOTATATE treatment of NET patients. Eur J Nucl Med Mol Imaging. 2022;49(11):3830\u201340.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"11","key":"1769_CR4","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1080\/17474124.2019.1685381","volume":"13","author":"S Das","year":"2019","unstructured":"Das S, Al-Toubah T, El-Haddad G, Strosberg J. 177Lu-DOTATATE for the treatment of gastroenteropancreatic neuroendocrine tumors. 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Curr Oncol. 2020;28(1):115\u201327.","journal-title":"Curr Oncol"}],"container-title":["Japanese Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11604-025-01769-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11604-025-01769-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11604-025-01769-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T08:51:06Z","timestamp":1757148666000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11604-025-01769-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,29]]},"references-count":13,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["1769"],"URL":"https:\/\/doi.org\/10.1007\/s11604-025-01769-7","relation":{},"ISSN":["1867-1071","1867-108X"],"issn-type":[{"value":"1867-1071","type":"print"},{"value":"1867-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,29]]},"assertion":[{"value":"12 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was conducted after receiving approval from the Institutional Ethics Committee at Fukushima Medical University (REC2023-160).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This study was performed per the ethical standards as laid down in the 1964 Declaration of Helsinki.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}