Severe GI Bleeding After Radioactive Peptide Therapy for Intestinal Cancer | Research

The takeaway

A patient developed recurrent gastrointestinal bleeding requiring ICU admission and surgery after three cycles of 177Lu-DOTATATE peptide receptor radionuclide therapy for intestinal neuroendocrine tumor.

4 ICU admissions, 14 transfusions
Severe recurrent GI bleeding after 3 cycles of 177Lu-DOTATATE PRRT

What the researchers found

Three cycles of 177Lu-DOTATATE PRRT for small intestine neuroendocrine tumor led to recurrent GI bleeding requiring four ICU admissions, 14 packed cell transfusions, and eventual surgery.

Why it matters

As PRRT becomes more widely used for neuroendocrine tumors, recognizing this serious GI bleeding complication is critical for patient safety and monitoring.

How the study worked

Single case report of severe GI bleeding complication following PRRT with 177Lu-DOTATATE for small intestine neuroendocrine tumor.

What this study cannot tell us

Single case report — incidence of this complication is unknown. Individual patient factors may have contributed to the severity.

How to read the evidence

Single case report — lowest level of evidence but important for safety awareness.

When this study was published

Published in 2026; highlights a complication of increasingly common PRRT treatment.

The bigger picture

This underscores that targeted radionuclide therapies, while effective, can cause significant collateral damage to normal tissue near tumors, requiring careful risk-benefit assessment.

Questions still open

How common is GI bleeding after PRRT for intestinal NETs?
Should patients with intestinal neuroendocrine tumors be monitored differently for GI bleeding during PRRT?

Common questions

What is PRRT?

Peptide receptor radionuclide therapy uses radioactive peptides that bind to specific receptors on tumor cells, delivering targeted radiation. 177Lu-DOTATATE (Lutathera) is the most commonly used PRRT agent for neuroendocrine tumors.

Is PRRT safe?

PRRT is generally well-tolerated, but this case shows it can cause serious complications, especially when tumors are located in the intestinal wall where radiation damage can lead to bleeding.

Read the original research

Recurrent gastrointestinal bleeding after Peptide Receptor Radionuclide Therapy for a small intestine neuroendocrine tumor.

Acta gastro-enterologica Belgica, 89(1), 83-86

View on PubMed ↗Publisher’s paper ↗

Citation

Brackenier, C; Leupe, H; Dekervel, J; Verslype, C; De Hertogh, G; Topal, H; Rasschaert, G; Deroose, C M; Van Herpe, F. (2026). Recurrent gastrointestinal bleeding after Peptide Receptor Radionuclide Therapy for a small intestine neuroendocrine tumor.. Acta gastro-enterologica Belgica, 89(1), 83-86. https://doi.org/10.51821/89.1.14522