Lee Jeongshim, Choi Jinhyun, Choi Chihwan, Seong Jinsil
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2013 Sep;31(3):125-30. doi: 10.3857/roj.2013.31.3.125. Epub 2013 Sep 30.
We investigated the role of radiotherapy (RT) for pancreatobiliary neuroendocrine tumors (PB-NETs).
We identified 9 patients with PB-NETs who received RT between January 2005 and March 2012. Of these 9 patients, 4 were diagnosed with NETs in the pancreas and 5 were diagnosed with NETs in the gallbladder. All patients received RT to the primary tumor or resection bed with a median total irradiation dose of 50.4 Gy, with or without chemotherapy.
The tumor response rate and tumor control rate in the RT field were 60% and 100 %, respectively. All 4 patients who underwent surgery had no evidence of disease in the RT field. Of the 5 patients who received RT to the primary gross tumor, 1 had complete response, 2 had partial response, and 2 had stable disease in the RT field. The median time to progression was 11 months. Of the 9 patients, four patients had no progression, and 5 patients had progression of disease (locoregional, 2; distant, 2; locoregional/distant, 1). Of the 4 patients without progression, 3 were treated with RT in adjuvant or neoadjuvant setting, and one received RT to primary tumor. One patient experienced radiation-induced duodenitis at 3 months after concurrent chemoradiation without treatment-related mortality.
RT can yield local control for advanced PB-NETs. RT should be considered an essential part of multimodality treatment in management of advanced PB-NETs.
我们研究了放射治疗(RT)在胰胆神经内分泌肿瘤(PB-NETs)中的作用。
我们确定了9例在2005年1月至2012年3月期间接受RT的PB-NETs患者。在这9例患者中,4例被诊断为胰腺神经内分泌肿瘤,5例被诊断为胆囊神经内分泌肿瘤。所有患者均接受了针对原发肿瘤或切除床的RT,中位总照射剂量为50.4 Gy,同时接受或不接受化疗。
RT区域的肿瘤反应率和肿瘤控制率分别为60%和100%。所有4例接受手术的患者在RT区域均无疾病证据。在5例接受原发大肿瘤RT的患者中,1例完全缓解,2例部分缓解,2例在RT区域疾病稳定。中位进展时间为11个月。9例患者中,4例无进展,5例疾病进展(局部区域进展2例;远处转移2例;局部区域/远处转移1例)。在4例无进展的患者中,3例在辅助或新辅助治疗中接受了RT,1例接受了原发肿瘤的RT。1例患者在同步放化疗后3个月出现放射性十二指肠炎症,无治疗相关死亡。
RT可实现晚期PB-NETs的局部控制。RT应被视为晚期PB-NETs多模式治疗的重要组成部分。