Department of Oncology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510407, China.
Future Oncol. 2013 Jun;9(6):909-13. doi: 10.2217/fon.13.48.
Pancreatic neuroendocrine tumors (PNETs) are rare, accounting for approximately 2% of primary malignant tumors of the pancreas. Compared with common pancreatic ductal adenocarcinomas, they grow more slowly, are less invasive and have a better prognosis. At present, surgery is the preferred method of treatment of PNETs, and offers the only chance of a cure. However, owing to the occult onset of PNETs, once diagnosed they are often inoperable when the diagnosis is established, and the optimal treatment of patients with inoperable liver metastases remains uncertain. In recent years, targeted drug therapies have emerged and have proved effective in prolonging progression-free survival in patients with advanced well-differentiated PNETs, but hardly any progress has been made in the treatment of poorly differentiated PNETs. In the patient described in this report, who had a poorly differentiated PNET with multiple hepatic metastases and had refused cytotoxic chemotherapy, oral sunitinib malate treatment for 22 months with regular follow-ups proved tolerable and effective in significantly reducing the size of the intrahepatic masses.
胰腺神经内分泌肿瘤（PNETs）较为罕见，约占胰腺原发性恶性肿瘤的 2%。与常见的胰腺导管腺癌相比，其生长更缓慢，侵袭性更低，预后更好。目前，手术是 PNETs 的首选治疗方法，是唯一有治愈机会的方法。然而，由于 PNETs 的隐匿性发病，一旦确诊时往往已无法手术，而对于无法手术的肝转移患者的最佳治疗仍不确定。近年来，出现了靶向药物治疗方法，已被证明可有效延长晚期高分化 PNET 患者的无进展生存期，但在低分化 PNET 的治疗方面几乎没有取得任何进展。在本报告中描述的患者，患有多发肝转移的低分化 PNET，并拒绝细胞毒性化疗，口服舒尼替尼马来酸盐治疗 22 个月，并定期随访，结果证明其耐受性好且有效，可显著缩小肝内肿块的大小。
