Targeted radiotherapy for small cell lung cancer using 90Yttrium-DOTATOC, an Yttrium-labelled somatostatin analogue: a pilot trial

Lung Cancer. 2004 Sep;45(3):365-71. doi: 10.1016/j.lungcan.2004.02.020.


Background: Some small cell lung carcinomas (SCLC) express neuro-endocrine markers, such as somatostatin receptors. Therefore, somatostatin analogues can be radio-labelled with 111Indium (Octreoscan) for diagnostic scintigraphy, or with 90Y-DOTATOC for therapeutic use. This is the first trial to assess the toxicity and efficacy of treatment with 90Y-DOTATOC in patients with Octreoscan positive SCLC.

Methods: Patients with SCLC after > or =first line chemotherapy received an Octreoscan scintigraphy and results were compared to CT scans. Patients with strong somatostatin-receptor expression were treated with 60 mCi/m2 90Y-DOTATOC i.v. every 3 weeks, for a total of three cycles. Major inclusion criteria were measurable tumour lesions, disease progression, normal creatinine clearance, PS < or = 2.

Results: Octreoscan scintigraphy identified 70% of all primary tumours, 87% of all mediastinal lesions, but only 26% of all extrathoracic tumour manifestations. Six patients were treated. Median number of 90Y-DOTATOC cycles was 2 (1-3). The only grade 3 toxicity was fatigue (n = 2) and dyspnea (n = 1). There were no severe renal or haematological toxicities. All six patients had tumour progression, median progression free survival (PFS) was 37.5 days (28-52) and median overall (OS) was 103.5 days (28-269).

Conclusion: This is the first report of somatostatin-receptor targeted radiotherapy for SCLC in the literature. In contrast to well differentiated neuro-endocrine tumours, 90Y-DOTATOC seems to be inactive in SCLC.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Carcinoma, Small Cell / diagnostic imaging
  • Carcinoma, Small Cell / pathology
  • Carcinoma, Small Cell / radiotherapy*
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Octreotide / administration & dosage
  • Octreotide / analogs & derivatives*
  • Octreotide / therapeutic use*
  • Radionuclide Imaging
  • Radiopharmaceuticals / administration & dosage
  • Radiopharmaceuticals / therapeutic use*
  • Yttrium Radioisotopes / administration & dosage
  • Yttrium Radioisotopes / therapeutic use*


  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • Octreotide
  • Edotreotide