Kim Shin Young, Woo In Sook, Yang Ji Hyun, Han Chi Wha, Roh Sang Young, Jung Yun Hwa
Division of Hematology-Oncology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Case Rep Oncol. 2014 Apr 17;7(1):266-72. doi: 10.1159/000362516. eCollection 2014 Jan.
Despite remarkable progression in the treatment and classification system of neuroendocrine tumor (NET), some questions have remained unanswered. The lack of an established treatment strategy for gastric NET is one of the problems. Because of its paucity, gastric NET is not discussed in independent, large-scaled prospective studies and tends to be excluded from clinical trials. Moreover, a separate classification system and some distinguished clinical features render the treatment of gastric NET more complicated. Here, we present a case of a female gastric NET patient with G2 proliferation index and multiple liver metastases. Based on the histologic grade and a high serum gastrin level, we initially treated her with somatostatin analogue. However, the patient did not respond. After that, cytotoxic chemotherapy with the etoposide plus cisplatin regimen only showed response in the short-term period. However, combination therapy with octreotide and interferon brought about significant regression of the tumor. Herein, we present our case together with a literature review of the treatment of metastatic gastric NET.
尽管神经内分泌肿瘤（NET）的治疗和分类系统取得了显著进展，但仍有一些问题未得到解答。缺乏针对胃神经内分泌肿瘤的既定治疗策略就是其中之一。由于其罕见性，胃神经内分泌肿瘤未在独立的大规模前瞻性研究中进行讨论，并且往往被排除在临床试验之外。此外，单独的分类系统和一些独特的临床特征使胃神经内分泌肿瘤的治疗更加复杂。在此，我们报告一例具有G2增殖指数和多发肝转移的女性胃神经内分泌肿瘤患者。基于组织学分级和高血清胃泌素水平，我们最初用生长抑素类似物对她进行治疗。然而，患者没有反应。之后，依托泊苷加顺铂方案的细胞毒性化疗仅在短期内显示出反应。然而，奥曲肽和干扰素联合治疗使肿瘤显著消退。在此，我们展示我们的病例，并对转移性胃神经内分泌肿瘤的治疗进行文献综述。
