Zubiri Leyre, Bilbao José I, Rodríguez Javier, Sangro Bruno
Medical Oncology, Clínica Universidad de Navarra, Pamplona, Spain.
Interventional Radiology, Clínica Universidad de Navarra, Pamplona, Spain.
Hepat Oncol. 2018 Sep 28;5(2):HEP09. doi: 10.2217/hep-2017-0025. eCollection 2018 Apr.
The hormone secretion in pancreatic neuroendocrine tumors (pNET) causes an important interference in patients' quality of life. We present two cases of pNET metastatic to the liver (a pancreatic endocrine carcinoma with a severe hormonal syndrome and an insulinoma with severe crisis of hypoglycemia and coma) refractory to conventional treatments, which were finally solved with selective internal radiation therapy (SIRT), a nonstandard level 1 therapy. We show two examples of an excellent control of symptoms together with a long survival after treatment with SIRT. The evidence supporting the use of this therapy is level 2. Our case reports strongly support the use of SIRT for the severe clinical syndrome in pNET metastatic to the liver and refractory to somatostatin analogs.
胰腺神经内分泌肿瘤（pNET）中的激素分泌对患者的生活质量造成了重要干扰。我们展示了两例转移至肝脏的pNET病例（一例为伴有严重激素综合征的胰腺内分泌癌，另一例为伴有严重低血糖危机和昏迷的胰岛素瘤），这些病例对传统治疗无效，最终通过选择性内放射治疗（SIRT）得以解决，这是一种非标准的1级治疗方法。我们展示了两个例子，表明SIRT治疗后症状得到了极佳控制，且生存期延长。支持使用这种治疗方法的证据为2级。我们的病例报告有力地支持了SIRT用于治疗转移至肝脏且对生长抑素类似物耐药的pNET严重临床综合征。
