This is a treatment that delivers radiation directly to cancer cells. It is injected into a vein, and travels in the bloodstream to the cancer cells.

The treatment consists of a radioactive substance combined with a substance that attaches to specific receptors on some cancer cells.

Radionuclide therapy that can be used to treat NETS include:

• peptide receptor radionuclide therapy (PRRT)
• radioactive iodine MIBG (131 I-MIBG) – mainly used to treat paragangliomas and phaeochromocytomas.

Peptide receptor radionuclide therapy (PRRT)

Some NETs have a large number of somatostatin receptors on their cells. Peptide receptor radionuclide therapy (PRRT) can be used to deliver high levels of radiation directly to these cells.

PRRT combines a radioactive substance with a manmade version of somatostatin called a somatostatin analogue. The somatostatin analogue attaches to the somatostatin receptors on the NET cells and the radioactive substance kills or damages the cells. PRRT may be given in combination with chemotherapy.

A Ga68 PET/CT scan will be done before PRRT to identify the presence of somatostatin receptors (SSTR) – if the scan is positive for SSTR then PRRT may be given.

The main type of PRRT is Lutate therapy, In NSW, this is only available at two centres.

Radioactive iodine MIBG (131 I-MIBG) 

This treatment uses radioactive iodine (I-131) combined with a substance called MIBG which targets receptors on some NET cells. The MIBG attaches to the receptors and the radioactive iodine kills or damages the cells.

External beam radiation therapy (EBRT) uses beams of X-rays or other radiation to treat cancer from outside the body. The beams are produced by a large machine called a linear accelerator.

There are several different types of EBRT. Most involve having treatment 5 days a week for a number of weeks. Others only need a small number of treatments.

Before starting radiation therapy you will go to a simulation or planning session to work out how you will be positioned for treatment.

When you go for each treatment, most of the time is used to set you up in the right position. The actual radiation beam is only on for a few minutes.

EBRT is not painful and you won’t feel anything during the treatment. You will hear some buzzing noises and the machine will move around you but it won’t touch you. The radiation therapist can see and hear you throughout the treatment.