Arrangements prior to treatment
Once the decision to proceed has been taken the team should:
- download the protocol in clinic and file in the patient's notes.
- download the QoL questionnaire and complete at baseline and at each assessment vist before the next treatment cycle
Eligibility for therapy for all patients will be discussed in a multidisciplinary setting.
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Inclusion criteria |
Contraindications to treatment |
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Somatostatin-receptors on tumour lesions demonstrated by octreotide scan or 68 Ga-DOTATATE PET CT scan within 6 months of first dose. Tumour uptake using this imaging should be at least as high as normal liver uptake on planar imaging.
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Pregnancy and lactation.
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Metastatic disease
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Renal impairment; creatinine clearance (eGFR) <40 mL/min.
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Life expectancy at least 3-6 months.
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Impaired haematological function; Hb < 8 g/dL, WCC < 2 x 109/L, platelets <75 x 109/L
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ECOG Performance Status 2 or above (see page 3) or
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Severe hepatic impairment; bilirubin >3 x ULN, ALT/AST >3 x ULN or albumin <30g/L with increased prothrombin time.
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Severe cardiac impairment*
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* In patients where this may be a concern, particularly those with metastatic carcinoid syndrome, a baseline echocardiogram should be performed pre-treatment prior to discussion about patient eligibility for Lu-177 treatment.
Patients attend M30 clinic 2 weeks before each treatment cycle to ensure that they meet the criteria for subsequent treatment. Treatment cycles are approximately every 12-16 weeks for 3 - 4 cycles. | 
