Gastroenteropatic neuroendocrine tumors: multidisciplinary approach in therapy

Czech version

Authors: S. Kiňová; Ľ. Kekeňák; E. Kováčová; M. Koreň
Authors‘ workplace: I. interná klinika Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednostka doc. MU Dr. Soňa Kiňová, PhD.
Published in: Vnitř Lék 2010; 56(9): 946-950
Category: 60th Birthday - Andrej Dukat MD, Csc., FESC

Overview

Introduction:
Gastroenteropancreatic neuroendocrine tumors (GEP‑ NET) are classified on the basis of hormonal activity of tumor cells to functional and non‑functional tumors. Therapy of well differentiated NETs includes surgical procedures, debulking of tumor mass, biotherapy and peptid receptor radionuclid therapy.

Aim of the study:
Analysis of therapeutic modalities in group of patients with well differentiated GEP‑ NETs.

Results:
In time period from 1. 1. 2005 to 1. 1. 2010 we followed up 50 pts (19 men/ 31 women) with well differentiated GEP neuroendocrine tumors. Primary localisation was: stomach – 6 times, pancreas – 9 times, duodenum – 1 times, jejunum – 4 times, appendix – 3 times, ileum – 23 times, rectum – 4 times. Metastatic disease was affirmed in time of diagnosis in 36 patients. Carcinoid syndroma had 20 pts, 4 pts with pancreatic tumor had functional tumors (2 times overproduction of calcitonine, 1 times of gastrin, 1 times of insuline). Surgical treatment was performed in 40 pts – resection of primary tumor and debulking of metastases, in 5 pts with pancreatic tumor resection was not possible due to invasion to sorrounding tissue and vessels. Biological treatment with long acting somatostatin analogues was indicated in 20 pts with carcinoid syndroma and in 4 pts with functional pancreatic tumors. In 5 pts with non resectable neuroendocrine carcinoma of pancreas peptid radionuclide receptor therapy (PRRT) was indicated: in 4 of them with ⁹⁰Ytrium‑ DOTA‑ octreotid and in 1 patient with MIBG. In all pts a reduction of tumor volume was noticed. Biotherapy with somatostatin analogues reduced symptoms of hormonal activities and brought on stabilisation of disease in most of patients. In period of follow up 5 patients died.

Conclusion:
Complex therapy in patients with well differentiated neuroendocrine tumors markedly contributes to prolongation of survival of patients and also to enhancement quality of their life.

Key words:
gastroenteropatic neuroendocrine tumor – biological therapy with somatostatin analoge – 5- hydroxyindolacetic acid – chromogranin A

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