Kirchhoff T, Chavan A, Galanski M
Department of Diagnostic Radiology, Hannover Medical School, Germany.
Eur J Gastroenterol Hepatol. 2000 Feb;12(2):141-3. doi: 10.1097/00042737-200012020-00001.
Gastrointestinal neuroendocrine tumours, i.e. carcinoids and islet cell tumours, often metastasize diffusely into the liver, rendering complete surgical resection impossible. Unlike other malignancies, prolonged survival may occur even in advanced disease. Chemotherapy of these rare tumours is not only aimed at size reduction (objective response) but also at symptom reduction (biological response). Systemic therapy, using 5-fluorouracil, doxorubicin, cisplatin, cyclophosphamide, somatostatin-analogue, interferon or streptozotocin yielded response rates of up to 69%. Since neuroendocrine tumours are generally hypervascular locoregional chemotherapy and chemoembolization also have been used successfully. However, even though severe complications are rare, some degree of pain and the post-embolization syndrome are almost inevitably present. The expected therapeutic efficacy must be weighed against possible side effects. The best result that can be hoped for in the chemoembolization of intestinal neuroendocrine metastatic disease is, as yet, only palliation.
胃肠道神经内分泌肿瘤，即类癌和胰岛细胞瘤，常弥漫性转移至肝脏，导致无法进行完整的手术切除。与其他恶性肿瘤不同，即使在疾病晚期也可能出现较长时间的生存。这些罕见肿瘤的化疗不仅旨在缩小肿瘤大小（客观缓解），还旨在减轻症状（生物学反应）。使用5-氟尿嘧啶、阿霉素、顺铂、环磷酰胺、生长抑素类似物、干扰素或链脲佐菌素的全身治疗有效率高达69%。由于神经内分泌肿瘤通常血供丰富，局部化疗和化疗栓塞也已成功应用。然而，尽管严重并发症很少见，但几乎不可避免地会出现一定程度的疼痛和栓塞后综合征。必须权衡预期的治疗效果与可能的副作用。对于肠道神经内分泌转移性疾病的化疗栓塞，目前所能期望的最佳结果也只是姑息治疗。
