Kettenbach Joachim, Müller Stefan Leonhard, Schindl Martin
Klinische Abteilung für Angiographie und Interventionelle Radiologie, Universitätsklinik für Radiodiagnostik, Allgemeines Krankenhaus, Wien, Osterreich.
Wien Klin Wochenschr. 2003;115 Suppl 2:56-64.
Neuroendocrine tumors are rare and slowly progressing malignancies, developing predominantly in the gastrointestinal tract. Thus, symptoms often develop late in patients with advanced disease. In 40-60% of patients, liver metastases are already unresectable and the resultant liver insufficiency is a common cause of death. A more aggressive role by the radiologist in diagnosis and interventional management of liver metastases using transarterial (chemo)embolisation and percutaneous ablation techniques such as using ethanol, laser, and radiofrequency did not seriously interfere with the lifestyle of the patient and improved survival. Due to many variables of the interventional techniques used and due to the low incidence of neuroendocrine tumors, no randomized data is available. However, the low morbidity of interventional management in neuroendocrine liver metastasis allows effective therapy with good palliation.
神经内分泌肿瘤是罕见的、进展缓慢的恶性肿瘤,主要发生在胃肠道。因此,晚期疾病患者的症状往往出现较晚。40%-60%的患者肝脏转移灶已无法切除,由此导致的肝功能不全是常见的死亡原因。放射科医生在肝转移瘤的诊断和介入治疗中发挥更积极的作用,采用经动脉(化疗)栓塞和经皮消融技术,如使用乙醇、激光和射频,不会严重影响患者的生活方式,并可提高生存率。由于所采用的介入技术存在许多变量,且神经内分泌肿瘤的发病率较低,目前尚无随机数据。然而,神经内分泌肝转移瘤介入治疗的低发病率使得有效治疗和良好的姑息治疗成为可能。