胃肠胰神经内分泌肿瘤的治疗进展
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摘要
总结胃肠胰神经内分泌肿瘤(GEP-NENs)的治疗进展,为临床治疗GEP-NENs提供参考依据。通过查阅国内外相关文献,对GEP-NENs的治疗进展进行总结。随着内镜的使用及筛查技术的提高,GEP-NENs的检出率逐渐升高,临床医师有必要对其治疗方法有所掌握。早期肿瘤可通过内镜及手术治疗达到治愈的效果,晚期肿瘤可通过全身化疗、靶向治疗(依维莫司、舒尼替尼)、放射性核素治疗等手段延缓肿瘤发展、抑制肿瘤增殖以延长生命。目前虽然该疾病得到重视,治疗水平有所提高,但仍有很多难题,探索的步伐不曾停止。
To summarize the treatment progress of gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs), and to provide references for clinical treatment of GEP-NENs. By consulting the relevant literatures at our country and abroad, the treatment progress of GEP-NENs was summarized. With the use of endoscopy and the improvement of screening technology,the detection rate of GEP-NENs gradually increase. It is necessary for clinicians to master the treatment methods of GEPNENs. Early neoplasms can be cured by endoscopy and surgical treatment. Survival time of patients with advanced neoplasms can be prolonged by systemic chemotherapy, targeted therapy(everolimus, sunitinib), radionuclide therapy and other means to delay the development of neoplasms and inhibit the proliferation of neoplasms. Although attention has been paid to the disease and the level of treatment has been improved, there are still many problems and the pace of exploration has not stopped.
To summarize the treatment progress of gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs), and to provide references for clinical treatment of GEP-NENs. By consulting the relevant literatures at our country and abroad, the treatment progress of GEP-NENs was summarized. With the use of endoscopy and the improvement of screening technology,the detection rate of GEP-NENs gradually increase. It is necessary for clinicians to master the treatment methods of GEPNENs. Early neoplasms can be cured by endoscopy and surgical treatment. Survival time of patients with advanced neoplasms can be prolonged by systemic chemotherapy, targeted therapy(everolimus, sunitinib), radionuclide therapy and other means to delay the development of neoplasms and inhibit the proliferation of neoplasms. Although attention has been paid to the disease and the level of treatment has been improved, there are still many problems and the pace of exploration has not stopped.
引文
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[16]张雨,陈旻湖,陈洁.胰腺神经内分泌肿瘤的内科治疗进展[J].胃肠病学,2017,22(2):65-69.
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[20]HERFERT J.Neuroendocrine tumors of the stomach(gastric carcinoids)are on the rise:small tumors,small problems?[J].Endoscopy,2010,42(8):664-671.
[21]应红艳,白春梅,陈原稼,等.晚期胃肠胰腺神经内分泌肿瘤靶向治疗进展[J].癌症进展,2011,9(5):501-506.
[22]HOPFNER M,SUTTER AP,GERST B,et al.A novel approach in the treatment of neuroendocrine gastrointestinal tumours.Targeting the epidermal growth factor receptor by gefitinib(ZD1839)[J].Br J Cancer,2003,89(9):1766-1775.
[23]CASTELLANO D,CAPDEVILA J,SASTRE J,et al.Sorafenib and bevacizumab combination targeted therapy in advanced neuroendocrine tumour:a phaseⅡstudy of Spanish Neuroendocrine Tumour Group(GETNE0801)[J].Eur J Cancer,2013,49(18):3780-3787.
[24]李焱冬,王晔,丁士刚.胃肠道神经内分泌肿瘤的药物治疗进展[J].胃肠病学,2017,22(9):569-571.
[25]FOLKERT IW,HERNANDEZ P,ROSES RE.Multidisciplinary management of nonfunctional neuroendocrine tumor of the pancreas[J].World J Gastroenterol,2016,22(11):3105-3116.
[2]刘丹,沈琳,陆明.胃神经内分泌肿瘤的诊断和治疗[J].临床肿瘤学杂志,2015,20(6):549-554.
[3]KWON YH,JEON SW,KIM GH,et al.Long-term follow up of endoscopic resect ion for type 3 gastric NET[J].World J Gastroenterol,2013,19(46):8703-8708.
[4]RYDZEWSKA G,CICHOCKI A,CWIK覵A J,et al.Endocrine tumors of the stomach and duodenum(including gastrinoma)-management guidelines(recommended by the Polish Network of Neuroendocrine Tumors)[J].Endokrynol Pol,2015,59(1):57-67.
[5]MORIS D,NTANASISSTATHOPOULOS I,TSILIMIGRAS DI,et al.Update on surgical management of small bowel neuroendocrine tumors[J].Anticancer Res,2018,38(3):1267-1278.
[6]YAMAGUCHI T,MACHIDA N,MORIZANE C,et al.Multicenter retrospective analysis of systemic chemotherapy for advanced neuroendocrine carcinoma of the digestive system[J].Cancer Sci,2014,105(9):1176-1181.
[7]BERRUTI A,FAZIO N,FERRERO A,et al.Bevacizumab plus octreotide and metronomic capecitabine in patients with metastatic well-to-moderately differentiated neuroendocrine tumors:the xelbevoct study[J].BMC Cancer,2014,14(1):184.
[8]RYDZEWSKA G,CICHOCKI A,CWIK覵A J,et al.Gastroduodenal neuroendocrine neoplasms,including gastrinoma-management guidelines(recommended by the Polish Network of Neuroendocrine Tumours)[J].Endokrynol.Pol,2013,64(6):444-458.
[9]SAIF MW,KALEY K,BRENNAN M,et al.A retrospective study of capecitabine/temozolomide(CAPTEM)regimen in the treatment of metastatic pancreatic neuroendocrine tumors(pNETs)after failing previous therapy[J].JOP,2013,14(5):498-501.
[10]蔺武军,毕玉田,陈东风.胰腺神经内分泌肿瘤的诊治进展[J].胃肠病学和肝病学杂志,2017,26(2):234-238.
[11]KRUG S,GRESS TM,MICHL P,et al.The role of cytotoxic chemotherapy in advanced pancreatic neuroendocrine tumors[J].Digestion,2017,96(2):67-75.
[12]LI TT,QIU F,QIAN ZR,et al.Classification,clinicopathologic features and treatment of gastric neuroendocrine tumors[J].World J Gastroenterol,2014,20(1):118-125.
[13]HANFORD Y,MUSTAFA K,QUINN SL,et al.Octreotide long-acting repeatable in the treatment of neuroendocrine tumors:patient selection and perspectives[J].Biologics,2017,11:115-122.
[14]ITO T,HONMA Y,HIJIOKA S,et al.PhaseⅡstudy of lanreotide autogel in Japanese patients with unresectable or metastatic well-differentiated neuroendocrine tumors[J].Invest New Drugs,2017,35(4):499-508.
[15]EDWARD W,BARBARA J,BARBRO E,et al.PhaseⅢstudy of pasireotide long-acting release in patients with metastatic neuroendocrine tumors and carcinoid symptoms refractory to available somatostatin analogues[J].Drug Des Devel Ther,2015,9:5075-5086.
[16]张雨,陈旻湖,陈洁.胰腺神经内分泌肿瘤的内科治疗进展[J].胃肠病学,2017,22(2):65-69.
[17]RAYMOND E,DAHAN L,RAOUL JL,et al.Sunitinib malate for the treatment of pancreatic neuroendocrine tumors[J].N Engl J Med,2010,364(6):501-513.
[18]YAO JC,SHAH MH,ITO T,et al.Everolimus for advanced pancreatic neuroendocrine tumors[J].N Engl J Med,2011,364(6):514-523.
[19]YAO JC,GUTHRIE KA,MORAN C,et al.PhaseⅢprospective randomized comparison trial of depot octreotide plus interferon Alfa-2b versus depot octreotide plus bevacizumab in patients with advanced carcinoid tumors:SWOG S0518[J].J Clin Oncol,2017,35(15):1695-1703.
[20]HERFERT J.Neuroendocrine tumors of the stomach(gastric carcinoids)are on the rise:small tumors,small problems?[J].Endoscopy,2010,42(8):664-671.
[21]应红艳,白春梅,陈原稼,等.晚期胃肠胰腺神经内分泌肿瘤靶向治疗进展[J].癌症进展,2011,9(5):501-506.
[22]HOPFNER M,SUTTER AP,GERST B,et al.A novel approach in the treatment of neuroendocrine gastrointestinal tumours.Targeting the epidermal growth factor receptor by gefitinib(ZD1839)[J].Br J Cancer,2003,89(9):1766-1775.
[23]CASTELLANO D,CAPDEVILA J,SASTRE J,et al.Sorafenib and bevacizumab combination targeted therapy in advanced neuroendocrine tumour:a phaseⅡstudy of Spanish Neuroendocrine Tumour Group(GETNE0801)[J].Eur J Cancer,2013,49(18):3780-3787.
[24]李焱冬,王晔,丁士刚.胃肠道神经内分泌肿瘤的药物治疗进展[J].胃肠病学,2017,22(9):569-571.
[25]FOLKERT IW,HERNANDEZ P,ROSES RE.Multidisciplinary management of nonfunctional neuroendocrine tumor of the pancreas[J].World J Gastroenterol,2016,22(11):3105-3116.