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Lutetium therapy

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.

Inclusion criteria

Contraindications to treatment

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.



Pregnancy and lactation.



Metastatic disease


Renal impairment; creatinine clearance (eGFR) <40 mL/min.


Life expectancy at least 3-6 months.


Impaired haematological function; Hb < 8 g/dL, WCC < 2 x 109/L, platelets <75 x 109/L


 ECOG Performance Status 2 or above (see page 3) or


Severe hepatic impairment; bilirubin >3 x ULN, ALT/AST >3 x ULN or albumin <30g/L with increased prothrombin time.



Severe cardiac impairment*


* 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.