Rougier P, Ducreux M
Service Hépato-gastroentérologie, Hôpital Ambroise Paré, Boulogne, France.
Ital J Gastroenterol Hepatol. 1999 Oct;31 Suppl 2:S202-6.
The efficacy of chemotherapy on digestive neuro-endocrine tumours is not yet fully established and depends on the tumour type and on the differentiation of the neuro-endocrine tumours. Reports have indirectly suggested the superior activity of chemotherapy for pancreatic neuro-endocrine tumours than for metastatic carcinoid tumours (response rates around 60% vs 20%). Neuro-endocrine tumour differentiation is also a major factor and a higher chemotherapy efficacy (tumour responses: 69%) has been suggested in undifferentiated or poorly differentiated neuro-endocrine tumours which respond to chemotherapy, a little like small cell lung carcinomas. The efficacy of interferons has also been reported in phase II trials only, with symptomatic and biological responses in about 50% of the cases and tumour responses in 10 to 15%; some studies have suggested an interesting tumour growth control with prolonged survival but this efficacy has still to be investigated to clearly establish the best indications. The role of chemotherapy has to be discussed with surgeons and, in slowly progressing tumours, after the use of somatostatin analogues.
化疗对消化神经内分泌肿瘤的疗效尚未完全确立，且取决于肿瘤类型和神经内分泌肿瘤的分化程度。有报告间接表明，化疗对胰腺神经内分泌肿瘤的活性优于转移性类癌肿瘤（缓解率约为60%对20%）。神经内分泌肿瘤的分化也是一个主要因素，对于对化疗有反应的未分化或低分化神经内分泌肿瘤，化疗疗效更高（肿瘤缓解率：69%），这有点类似于小细胞肺癌。干扰素的疗效仅在II期试验中有报告，约50%的病例有症状缓解和生物学反应，10%至15%有肿瘤缓解；一些研究表明，通过延长生存期可实现有趣的肿瘤生长控制，但这种疗效仍有待进一步研究以明确最佳适应证。化疗的作用必须与外科医生讨论，对于进展缓慢的肿瘤，应在使用生长抑素类似物之后再考虑化疗。
