Chan Jennifer A, Kulke Matthew H
Department of Medical Oncology, Dana-Farber Cancer Institute, Dana 1220, 450 Brookline Avenue, Boston, MA 02215, USA.
Department of Medical Oncology, Dana-Farber Cancer Institute, Dana 1220, 450 Brookline Avenue, Boston, MA 02215, USA.
Surg Oncol Clin N Am. 2016 Apr;25(2):423-37. doi: 10.1016/j.soc.2015.11.009. Epub 2016 Feb 19.
When diagnosed at an early stage, resection of pancreatic neuroendocrine tumors (NETs) is often curative. Unfortunately, curative surgery is rarely an option for patients with metastatic disease. Multiple options are available for the management of patients with advanced pancreatic NETs, including surgery, liver-directed therapy, and systemic therapies. Because of the heterogeneity of disease biology and presentation, a multidisciplinary approach to management is critical. Treatment with somatostatin analogs, sunitinib, everolimus, and alkylating agents provide effective systemic therapeutic options for patients. Future studies to evaluate the optimal timing, sequence, and combination of therapies, as well as to identify predictors of response, are warranted.
胰腺神经内分泌肿瘤（NETs）在早期诊断时，手术切除通常可治愈。不幸的是，对于转移性疾病患者，根治性手术很少是一种选择。晚期胰腺NETs患者的管理有多种选择，包括手术、肝脏定向治疗和全身治疗。由于疾病生物学和表现的异质性，多学科管理方法至关重要。生长抑素类似物、舒尼替尼、依维莫司和烷化剂治疗为患者提供了有效的全身治疗选择。有必要进行未来研究，以评估治疗的最佳时机、顺序和联合方式，以及确定反应预测指标。
