Iwata Tomoyuki, Ueno Hideki, Itami Jun, Ito Yoshinori, Inaba Koji, Morizane Chigusa, Kondo Shunsuke, Sakamoto Yasunari, Shiba Satoshi, Sasaki Mitsuhito, Koga Futa, Okusaka Takuji
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital.
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
Jpn J Clin Oncol. 2017 Sep 1;47(9):826-831. doi: 10.1093/jjco/hyx081.
Detailed information regarding the clinical efficacy of radiotherapy (RT) for primary tumor in patients with unresectable pancreatic neuroendocrine tumors (pNETs) is unknown. We therefore performed a retrospective study to evaluate the efficacy and safety of RT for primary pancreatic tumors in patients with pNETs.
We investigated 11 patients with pNETs who received RT to the primary site between January 1997 and June 2015. Seven patients had Grade 2 neuroendocrine tumors (NET-G2) and four had neuroendocrine carcinoma (NEC) according to the 2010 WHO histopathological classification.
The tumor response and control rates were 27.2% and 100%, respectively (3: partial response, 8: stable disease). Among patients with NET-G2 tumors, the response rate was 28.5% (2/7 patients) and symptomatic improvement was noted in 33.3% of the patients (1/3 patients). The response rate for patients with NEC were 25% (1/4), one NEC patients with symptoms exhibited symptomatic improvement. The median overall survival and median progression-free survival were 35.9 months and 5.5 months, respectively. Grade 3 diarrhea as an acute toxicity and Grade 3 gastrointestinal hemorrhage as a late toxicity were observed.
RT to the primary cancer site in patients with pNETs was an effective modality for local disease control and the treated patients had good outcomes. If metastatic tumors are under control, RT to the primary site may be beneficial for patients with pNETs.
关于放疗（RT）对不可切除胰腺神经内分泌肿瘤（pNETs）患者原发性肿瘤的临床疗效的详细信息尚不清楚。因此，我们进行了一项回顾性研究，以评估RT对pNETs患者原发性胰腺肿瘤的疗效和安全性。
我们调查了1997年1月至2015年6月期间接受原发部位RT的11例pNETs患者。根据2010年世界卫生组织组织病理学分类，7例患者为2级神经内分泌肿瘤（NET-G2），4例为神经内分泌癌（NEC）。
肿瘤缓解率和控制率分别为27.2%和100%（3例：部分缓解，8例：病情稳定）。在NET-G2肿瘤患者中，缓解率为28.5%（2/7例患者），33.3%的患者（1/3例患者）有症状改善。NEC患者的缓解率为25%（1/4），1例有症状的NEC患者症状有所改善。中位总生存期和中位无进展生存期分别为35.9个月和5.5个月。观察到3级腹泻为急性毒性，3级胃肠道出血为晚期毒性。
pNETs患者对原发癌部位进行RT是局部疾病控制的有效方式，且接受治疗的患者预后良好。如果转移性肿瘤得到控制，对原发部位进行RT可能对pNETs患者有益。
