Arnold R, Simon B, Wied M
Department of Internal Medicine, Philipps University, Marburg, Germany.
Digestion. 2000;62 Suppl 1:84-91. doi: 10.1159/000051861.
Somatostatin and its long-acting analogues are effective in symptom control in patients with functionally active neuroendocrine GEP tumours. Several in vitro and in vivo reports suggest that they are also able to control tumour growth.
Critical review of published data on the effect of long-acting somatostatin analogues on symptom and growth control in patients with metastatic neuroendocrine GEP tumours.
With the exception of insulinoma and gastrinoma, octreotide acetate and other long-acting somatostatin formulations are currently the therapeutic principle of first choice to control hormone-mediated symptoms. The consequences of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome are best controlled by proton pump inhibitors. Available data on growth control indicate that stabilization of tumour growth seems to be the most beneficial antiproliferative effect occurring in up to 50% of patients. This effect is limited. However, it is unknown which tumour entity responds best to long- acting somatostatin analogues.
Additional studies in patients with known spontaneous tumour growth and avoiding a mix-up of different entities of neuroendocrine malignancies are necessary to identify subpopulations of neuroendocrine tumours which respond to long-acting somatostatin analogues in terms of longer lasting growth inhibition.
生长抑素及其长效类似物对功能性活跃的神经内分泌胃肠胰腺（GEP）肿瘤患者的症状控制有效。多项体外和体内研究报告表明，它们也能够控制肿瘤生长。
对已发表的关于长效生长抑素类似物对转移性神经内分泌GEP肿瘤患者症状和生长控制效果的数据进行批判性综述。
除胰岛素瘤和胃泌素瘤外，醋酸奥曲肽和其他长效生长抑素制剂目前是控制激素介导症状的首选治疗原则。卓-艾综合征患者胃酸分泌过多的后果最好用质子泵抑制剂控制。现有的生长控制数据表明，肿瘤生长稳定似乎是最有益的抗增殖作用，高达50%的患者会出现这种作用。然而，这种作用是有限的。目前尚不清楚哪种肿瘤实体对长效生长抑素类似物反应最佳。
有必要对已知有自发肿瘤生长的患者进行更多研究，并避免神经内分泌恶性肿瘤不同实体的混淆，以确定在持久生长抑制方面对长效生长抑素类似物有反应的神经内分泌肿瘤亚群。
