Kyushu University, Graduate School of Medical Sciences, Department of Medicine and Bioregulatory Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Expert Opin Pharmacother. 2013 Feb;14(3):307-21. doi: 10.1517/14656566.2013.767332. Epub 2013 Jan 30.
The role of pharmacotherapy in the management of patients with Zollinger-Ellison syndrome (ZES) is often equated with the medical management of acid hypersecretion. However, pharmacotherapy is also increasingly involved in the other management areas of these patients.
This paper reviews the role of pharmacotherapy in all aspects of the management of patients with ZES. Newer aspects are emphasized. This includes the difficulty of diagnosing ZES in patients taking proton pump inhibitors. Also covered is the role of pharmacotherapy in controlling acid hypersecretion and other hormonal hypersecretory states these patients may develop, including hyperparathyroidism in patients with multiple endocrine neoplasia type 1 and ZES; tumor localization; and the treatment of advanced metastatic disease. The last includes chemotherapy, liver-directed therapies, biotherapy (somatostatin/interferon), peptide radio-receptor therapy and molecular-targeted therapies including the use of mTor inhibitors (everolimus) and tyrosine kinase inhibitors (sunitinib).
Pharmacotherapy is now involved in all aspects of the management of patients with ZES, with the result that ZES has progressed from being considered an entirely surgical disease initially to the present where medical treatment plays a major role in almost all aspects of the management of these patients.
在 Zollinger-Ellison 综合征（ZES）患者的治疗中，药物治疗的作用通常等同于胃酸分泌过多的医学管理。然而，药物治疗也越来越多地涉及这些患者的其他治疗领域。
本文回顾了药物治疗在 ZES 患者所有治疗方面的作用。强调了新的方面。这包括在接受质子泵抑制剂治疗的患者中诊断 ZES 的困难。还包括药物治疗在控制胃酸分泌过多和这些患者可能发生的其他激素分泌过多状态（包括多发性内分泌肿瘤 1 型和 ZES 患者的甲状旁腺功能亢进）、肿瘤定位以及晚期转移性疾病的治疗中的作用。最后包括化疗、肝定向治疗、生物治疗（生长抑素/干扰素）、肽放射性受体治疗和分子靶向治疗，包括使用 mTor 抑制剂（依维莫司）和酪氨酸激酶抑制剂（舒尼替尼）。
药物治疗现在涉及 ZES 患者治疗的各个方面，其结果是 ZES 已从最初被认为是一种完全需要手术的疾病发展到现在，在这种疾病的几乎所有治疗方面，药物治疗都起着重要作用。
