Gardner-Roehnelt Nancy M
Neuroendocrine Tumor Division of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Clin J Oncol Nurs. 2012 Feb;16(1):56-64. doi: 10.1188/12.CJON.56-64.
Although neuroendocrine tumors (NETs) have been recognized as a family of complex malignancies since 1907, major progress has been made only in the past 20 years in understanding and managing the disease. The detection and reported incidence of NETs have increased fivefold since 1973, suggesting that the tumors may be more common than previously believed. NETs arise predominantly in the gastrointestinal tract but can occur in any tissue containing endocrine precursor cells and can secrete hormone peptides that exert clinical symptoms of flushing and diarrhea. With the introduction of the somatostatin analog (SSA) octreotide in 1987, symptom management of NETs improved by diminishing morbidities and mortality associated with carcinoid syndrome. Clinical results suggest that the SSA agents octreotide and lanreotide also may provide antitumor benefits in addition to their suppression of carcinoid syndrome. Oncology nurses should be aware of the expanded role of SSA agents for symptom management and tumor control in patients with NETs and communicate treatment benefits, side-effect management, and effective adherence with patients for the optimal clinical management of NETs.
尽管自1907年以来神经内分泌肿瘤（NETs）就被公认为是一类复杂的恶性肿瘤，但在过去20年里，在对该疾病的认识和管理方面才取得了重大进展。自1973年以来，NETs的检测率和报告发病率增长了五倍，这表明这些肿瘤可能比之前认为的更为常见。NETs主要起源于胃肠道，但可发生于任何含有内分泌前体细胞的组织，并能分泌引起潮红和腹泻等临床症状的激素肽。随着1987年生长抑素类似物（SSA）奥曲肽的引入，通过减少与类癌综合征相关的发病率和死亡率，NETs的症状管理得到了改善。临床结果表明，SSA药物奥曲肽和兰瑞肽除了能抑制类癌综合征外，还可能具有抗肿瘤作用。肿瘤专科护士应了解SSA药物在NETs患者症状管理和肿瘤控制方面的扩展作用，并与患者沟通治疗益处、副作用管理以及有效依从性，以实现NETs的最佳临床管理。
