Peptide Receptor Radionuclide Therapy (PRRT) will not work on all neuroendocrine tumors. For this treatment to work you MUST have somatostatin receptors in your tumors. When a somatostatin analog (like a form of octreotide) is combined with a radionuclide such as Lutetium-177 (LU177) or Yttrium-90 (Y90), it has a strong affinity for the somatostatin receptor subtype-2 that can exist in the NET tumor. This means that the radioactive material put in the body for the treatment will be absorbed directly by the tumor with the receptor causing the tumor to die.
PRRT is considered to be a systemic form of treatment that will affect neuroendocrine tumors with receptors wherever they are in the body. This form of treatment is used primarily for patients with non resecatable tumors in multiple sites. Some patients only having tumors in the liver are treated with this therapy in order to reduce the size and number of tumors present in the liver or other body areas in preparation for surgery.
In addition to needing somatostatin receptors in a patient's tumors, many factors must be weighed before deciding to pursue this form of treatment. Certainly tumor load in terms of size, number and location of tumors is critical. Others could be age and physical condition. Recent (Kwekkeboom et. al. January, 2010) research on the use of Lu-177 octreotate for PRRT indicated that such treatment should be started early in the disease evolution.