Oberg K, Norheim I, Theodorsson E
Ludwig Institute for Cancer Research, Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Acta Oncol. 1991;30(4):503-7. doi: 10.3109/02841869109092409.
Treatment with the somatostatin analogue octreotide, SMS 201-995 (Sandostatin), has been carried out in a series of 23 patients with malignant midgut carcinoid tumours. The patients received initially 50 micrograms twice a day for six months, thereafter a median of 100 micrograms twice daily. Six of 22 evaluable patients (28%) showed objective tumour response lasting for 6 to 30 months. Stable disease was observed in 8 of the 22 patients (36%) and progressive disease in a further 8 patients (36%). A subjective response with decrease of diarrhoea or flushing was noted in 11 out of 22 patients (50%). Two out of 6 patients with objective response demonstrated a significant decrease of tumour size lasting for 6 and 30 months respectively. In order to maintain the clinical response, the dose had to be increased in all 6 responders. The adverse effects included development of diabetic blood glucose levels in 8 out of 22 patients (36%). Albumin-modified serum calcium levels were significantly reduced after treatment with octreotide 50 micrograms twice a day. One patient developed symptoms of hypocalcemia which was reversed by supplementation with calcium and D-vitamins. The somatostatin analogue SMS 201-995 has a beneficial effect in the treatment of patients with the carcinoid syndrome. However, the precise role of the drug in the long-term management of these patients has to be further investigated.
已对23例恶性中肠类癌肿瘤患者使用生长抑素类似物奥曲肽（SMS 201-995，善得定）进行了治疗。患者最初每天两次接受50微克治疗，持续6个月，此后中位数为每天两次100微克。22例可评估患者中有6例（28%）出现客观肿瘤反应，持续6至30个月。22例患者中有8例（36%）观察到病情稳定，另有8例患者（36%）病情进展。22例患者中有11例（50%）出现腹泻或潮红减轻的主观反应。6例有客观反应的患者中有2例分别出现肿瘤大小显著缩小，持续6个月和30个月。为维持临床反应，所有6例有反应的患者均需增加剂量。不良反应包括22例患者中有8例（36%）出现糖尿病血糖水平。每天两次使用50微克奥曲肽治疗后，白蛋白修饰的血清钙水平显著降低。1例患者出现低钙血症症状，补充钙和维生素D后症状逆转。生长抑素类似物SMS 201-995在类癌综合征患者的治疗中具有有益作用。然而该药物在这些患者长期管理中的确切作用有待进一步研究。
