Peptide receptor radionuclide therapy (PRRT) is a treatment option for patients with advanced meningioma. Recently, intraarterial application of the radiolabeled somatostatin receptor agonists has been introduced as an alternative to standard intravenous administration. In this study, we assessed the safety and efficacy of intraarterial PRRT in patients with advanced, progressive meningioma. Methods: Patients with advanced, progressive meningioma underwent intraarterial PRRT with [¹⁷⁷Lu]Lu-HA-DOTATATE. The safety of PRRT was evaluated according to the Common Terminology Criteria for Adverse Events version 5.0. Treatment response was assessed according to the proposed Response Assessment in Neuro-Oncology criteria for meningiomas and somatostatin receptor–directed PET/CT. Results: Thirteen patients (8 women, 5 men; mean age, 65 ± 13 y) with advanced meningioma underwent 1–4 cycles (median, 4 cycles) of intraarterial PRRT with [¹⁷⁷Lu]Lu-HA-DOTATATE (mean activity per cycle, 7,428 ± 237 MBq; range, 6,000–7,700 MBq). Treatment was well tolerated with mainly grade 1–2 hematologic toxicity. Ten of 13 patients showed radiologic disease control at follow-up after therapy (1/10 complete remission, 1/10 partial remission, 8/10 stable disease), and 9 of 13 patients showed good control of clinical symptoms. Conclusion: Intraarterial PRRT in patients with advanced meningioma is feasible and safe. It may result in improved radiologic and clinical disease control compared with intravenous PRRT. Further research to validate these initial findings and to investigate long-term outcomes is highly warranted.

肽受体放射性核素疗法 （PRRT） 是晚期脑膜瘤患者的一种治疗选择。最近，放射性标记的生长抑素受体激动剂的动脉内应用已被引入作为标准静脉给药的替代方法。在这项研究中，我们评估了动脉内 PRRT 对晚期进行性脑膜瘤患者的安全性和有效性。方法：晚期进行性脑膜瘤患者接受了动脉内 PRRT 和 [¹⁷⁷Lu]Lu-HA-DOTATATE。根据不良事件通用术语标准 5.0 版评估 PRRT 的安全性。根据脑膜瘤和生长抑素受体定向 PET/CT 的神经肿瘤学标准中拟议的反应评估治疗反应。结果：13 例晚期脑膜瘤患者 （8 例女性，5 例男性;平均年龄 65 ± 13 岁） 接受了 1-4 个周期 （中位数，4 个周期） 动脉内 PRRT 和 [¹⁷⁷Lu]Lu-HA-DOTATATE （每个周期的平均活性，7,428 ± 237 MBq;范围， 6,000–7,700 MBq）。治疗耐受性良好，主要为 1-2 级血液学毒性。13 例患者中有 10 例在治疗后的随访中显示放射学疾病得到控制 （1/10 完全缓解，1/10 部分缓解，8/10 疾病稳定），13 例患者中有 9 例表现出良好的临床症状控制。结论：晚期脑膜瘤患者的动脉内 PRRT 是可行且安全的。与静脉注射 PRRT 相比，它可能会改善放射学和临床疾病控制。非常有必要进行进一步的研究来验证这些初步发现并调查长期结局。