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神经内分泌肿瘤中生长抑素类似物的胃肠道副作用:重点综述。

Gastrointestinal side effects of somatostatin analogs in neuroendocrine tumors: a focused review.

机构信息

Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy.

PhD in Translational Medicine and Oncology, Sapienza University of Rome, Rome, Italy.

出版信息

J Gastroenterol Hepatol. 2024 Sep;39(9):1737-1744. doi: 10.1111/jgh.16638. Epub 2024 May 23.

Abstract

Neuroendocrine tumors (NETs) are a group of well-differentiated heterogeneous neoplasms characterized by slow progression and distinct clinical and biological behavior. In the majority of patients with NET, first-line treatment is represented by somatostatin analogs (SSAs) that, despite being drugs with high tolerability (even at high doses) and providing to carcinoid symptoms control and anti-proliferative effects, may present some side effects, with potential impact on quality of life and nutritional status. The most frequent side effects are represented by gastrointestinal events in particular alterations in bowel habits (diarrhea and constipation), abdominal pain, exocrine pancreatic insufficiency, and cholelithiasis. Considering the relative rarity of NETs, literature about frequency and standard clinical management of adverse events SSA-related is still lacking and heterogeneous. The aim of this review is to arm gastroenterologists and other physicians treating NET patients with essential knowledge on the side effects of SSAs. By identifying and managing these adverse events early, healthcare professionals can offer optimal care, avert foreseeable complications, and ensure the best outcomes for patients. Without such early recognition, there is a risk of diminishing the patient's quality of life and their ability to sustain treatment over time.

摘要

神经内分泌肿瘤(NET)是一组分化良好的异质性肿瘤,其特征为进展缓慢,具有独特的临床和生物学行为。在大多数 NET 患者中,一线治疗方法是使用生长抑素类似物(SSA),尽管这些药物具有较高的耐受性(即使在高剂量下),可控制类癌症状并具有抗增殖作用,但可能会出现一些副作用,对生活质量和营养状况产生潜在影响。最常见的副作用是胃肠道事件,特别是肠道习惯改变(腹泻和便秘)、腹痛、外分泌胰腺功能不全和胆石症。鉴于 NET 的相对罕见性,关于 SSA 相关不良反应的频率和标准临床管理的文献仍然缺乏且存在异质性。本综述的目的是为治疗 NET 患者的胃肠病学家和其他医生提供有关 SSA 副作用的基本知识。通过早期识别和管理这些不良反应,医疗保健专业人员可以为患者提供最佳护理,避免可预见的并发症,并确保最佳的治疗效果。如果没有早期识别,患者的生活质量和持续治疗的能力可能会下降。

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