Angeletti S, Corleto V D, Schillaci O, Moretti A, Panzuto F, Annibale B, Delle Fave G
Dept. of Digestive Diseases, Cellular Biotechnology and Haematology, University La Sapienza Roma, Italy.
Ital J Gastroenterol Hepatol. 1999 Jan-Feb;31(1):23-7.
Somatostatin analogues are able to control symptoms and to detect tumour localisation in gastro-entero-pancreatic endocrine tumour patients. Few studies have evaluated the efficacy of somatostatin analogues in controlling tumoural growth during long-term treatment and, generally, a low efficacy has been reported in studies using multiple daily octreotide dosages. In the present study a single daily dose of octreotide (500 micrograms) for 1 year was used in the treatment of 10 patients with progressive gastro-entero-pancreatic metastatic tumour.
Ten consecutive patients (3 females, 7 males age range 40-62 years) were studied of whom 4 had Zollinger-Ellison syndrome (2 with MEN-1), 3 had a carcinoid syndrome, and 3 had a non-functional neuro-endocrine tumour. All patients, 6-12 months before octreotide treatment, showed tumour progression. In all patients, somatostatin receptor status was assessed by Somatostatin Receptor Scintigraphy and tumoural lesions by Magnetic Resonance Imaging. Appropriate tumoural markers were also evaluated.
At the three-month control, two patients (non-functional) showed an aggressive progression of tumoural growth despite treatment and were excluded from the study. One patient was lost during follow-up. Of the 7 remaining patients, imaging evaluation studies revealed, after 1 year of treatment, stable disease in 6 patients, whereas a partial tumoural response was observed in one patient (gastrinoma). Biochemical tumoural markers decreased with respect to basal values of 53-78% in these seven patients at the end of therapy.
These results suggest that one year of octreotide in a single daily dose (500 micrograms) is effective in the long-term stabilization of tumoural progression in metastatic gastro-entero-pancreatic tumour patients.
生长抑素类似物能够控制胃肠胰内分泌肿瘤患者的症状并检测肿瘤定位。很少有研究评估生长抑素类似物在长期治疗中控制肿瘤生长的疗效，而且一般来说，在使用每日多次奥曲肽剂量的研究中报道的疗效较低。在本研究中，采用每日单次剂量的奥曲肽（500微克）治疗10例进展期胃肠胰转移性肿瘤患者，疗程为1年。
连续研究了10例患者（3例女性，7例男性，年龄范围40 - 62岁），其中4例患有卓艾综合征（2例伴有多发性内分泌腺瘤病1型），3例患有类癌综合征，3例患有无功能性神经内分泌肿瘤。所有患者在奥曲肽治疗前6 - 12个月均显示肿瘤进展。所有患者均通过生长抑素受体闪烁扫描评估生长抑素受体状态，并通过磁共振成像评估肿瘤病变。还评估了适当的肿瘤标志物。
在三个月的对照期，2例患者（无功能性肿瘤）尽管接受了治疗，但肿瘤生长仍呈侵袭性进展，被排除在研究之外。1例患者在随访期间失访。在其余7例患者中，影像学评估研究显示，治疗1年后，6例患者病情稳定，而1例患者（胃泌素瘤）出现部分肿瘤反应。治疗结束时，这7例患者的生化肿瘤标志物相对于基础值下降了53 - 78%。
这些结果表明，每日单次剂量（500微克）的奥曲肽治疗1年对转移性胃肠胰肿瘤患者的肿瘤进展长期稳定有效。
