尽管基于 177Lu 的肽受体放射性核素疗法在治疗转移性神经内分泌肿瘤（NET）中有效，但治疗后疾病进展仍然是一个重大挑战。靶向α疗法（TAT）已成为经历此类进展的患者的一个有前途的选择。本研究旨在通过荟萃分析评估 TAT 对转移性 NET 患者的治疗效果和毒性。我们使用相关关键词对 PubMed、Embase、Cochrane Library 和 CINAHL 进行了全面检索。该分析重点关注客观缓解率 (ORR) 和疾病控制率 (DCR) 的汇总比例，以确定治疗效率。我们还评估了严重血液学和肾脏不良事件（3 级或 4 级）的发生率，以评估毒性。进行亚组分析以确定影响治疗结果的因素。我们的荟萃分析包括 7 项研究，涉及 162 名患者。结果显示，TAT 的 ORR 为 49.5%（95% 置信区间 [CI]：41.7%-57.4%），DCR 为 87.0%（95% CI：72.1%-96.8%）。血液学和肾脏毒性的发生率较低，分别为 2.1%（95% CI：0.5%-5.5%）和 3.4%（95% CI：1.2%-7.3%）。亚组分析表明不同变量的治疗效率一致，包括之前基于 177Lu 的肽受体放射性核素治疗、基于 225Ac 的 TAT、不使用放射增敏剂以及疗效评估方法，ORR 范围为 46.6% 至 57.1%，DCR 范围为 82.0%至 91.5%。TAT 是转移性 NET 的有效治疗方法，显示出显着的疾病控制和缓解率，且毒性最小。这些研究结果表明，TAT 对于转移性 NET 患者来说是一种可行的治疗替代方案。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

Despite the effectiveness of 177Lu-based peptide receptor radionuclide therapy in treating metastatic neuroendocrine tumors (NETs), disease progression posttreatment remains a significant challenge. Targeted alpha therapy (TAT) has emerged as a promising option for patients experiencing such progression. This study aims to assess the therapeutic efficiency and toxicity of TAT in patients with metastatic NET through a meta-analysis.We conducted a comprehensive search of PubMed, Embase, Cochrane Library, and CINAHL using relevant keywords. The analysis focused on the pooled proportions of objective response rate (ORR) and disease control rate (DCR) to determine therapeutic efficiency. We also evaluated the incidence of serious hematologic and renal adverse events (grade 3 or 4) to assess toxicity. A subgroup analysis was performed to identify factors influencing therapeutic outcomes.Our meta-analysis included 7 studies comprising 162 patients. The results showed that TAT achieved ORR of 49.5% (95% confidence interval [CI]: 41.7%-57.4%) and DCR of 87.0% (95% CI: 72.1%-96.8%). The incidences of hematologic and renal toxicities were low, at 2.1% (95% CI: 0.5%-5.5%) and 3.4% (95% CI: 1.2%-7.3%), respectively. Subgroup analysis indicated consistent therapeutic efficiency across different variables, including prior 177Lu-based peptide receptor radionuclide therapy treatment, 225Ac-based TAT, absence of radiosensitizer, and methods of response evaluation, with ORR ranging from 46.6% to 57.1% and DCR from 82.0% to 91.5%.TAT is an effective treatment for metastatic NET, demonstrating substantial disease control and response rates with minimal toxicity. These findings suggest that TAT is a viable therapeutic alternative for patients with metastatic NET.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.