胃肠道神经内分泌肿瘤的治疗现状及预后

胃肠道神经内分泌肿瘤(GE-NETs)是一组起源于消化道肽能神经元和神经内分泌细胞的恶性肿瘤,能产生多种肽类激素而引起特征性的内分泌综合征,但仅少数患者出现特异性的临床症状。治愈是治疗的首要目标,其次是控制症状及延缓肿瘤进展。手术是传统的一线治疗方案和唯一可达到治愈目的的有效方法。但是,多数患者因在初次诊断NETs时即已出现转移而失去手术根治机会。这部分患者需要接受长期的术后相关治疗,以达到缓解症状、抑制肿瘤生长转移、改善患者预后的目的。生长抑素类似物,如长效奥曲肽能缓解肿瘤所导致的临床症状并延缓其进展,且与生物靶向制剂如依维莫司联合应用对抑制肿瘤增殖具有协同作用。全身肽受体靶向放射治疗也是未来治疗NETs的新途径。

Current Medical Therapy Options and Prognosis of Gastrointestinal Neuroendocrine Tumors

Gastrointestinal Neuroendocrine Tumors(GE-NETs)are a genetically diverse group of malignancies which originate from the gastrointestinal peptide neurons and neuroendocrine cells that sometimes produce peptides causing characteristic hormonal syndromes,while only a few patients present specific syndromes.The primary treatment goal is cure,with symptom control and the limitation of tumor progression as secondary goals.Surgery is the traditional first-line therapy and the only possible curative approach.But,as metastases already happened at the first diagnosis of NETs in most cases,curative surgery is generally not possible.Therefore,these patients need chronic postoperative related treatment with the aim of relieving symptoms,suppressing tumor growth and spread,to improve the prognosis of patients.Somatostatin analogues,such as octreotide long-acting repeatable,can relieve the hormonal symptoms,slow down the tumour growth,and has shown synergistic antiproliferative activity in combination therapy with biological agent everolimus.Systemic peptide receptor-targeted radiotherapy is also a new treatment option for NETs.