生长抑素类似物与小胰腺神经内分泌肿瘤的主动监测对比
Somatostatin Analogs Versus Active Surveillance in Small Pancreatic Neuroendocrine Tumors.
作者信息
Maratta Maria Grazia, Chiloiro Sabrina, Raia Salvatore, Maiorano Brigida A, Horn Guido, Brizi Maria Gabriella, Rufini Vittoria, Giancipoli Romina Grazia, De Marinis Laura, Bianchi Antonio, Pontecorvi Alfredo, Schinzari Giovanni, Inzani Frediano, Tortora Giampaolo, Rindi Guido
机构信息
Fondazione Policlinico Universitario Agostino Gemelli - IRCCS - Università Cattolica del Sacro Cuore European NeuroEndocrine Tumor Society (ENETS) Center of Excellence for the Diagnosis and Cure of Neuroendocrine Tumors, Rome, Italy.
出版信息
Pancreas. 2025 Jul 1;54(6):e524-e529. doi: 10.1097/MPA.0000000000002425.
OBJECTIVES
The best strategy for nonfunctioning, sporadic, G1-G2 pancreatic neuroendocrine tumors ≤2 cm is unknown. An active surveillance is usually recommended. The PROMID and the CLARINET studies proved the value of somatostatin analog (SSA) treatment in advanced gastro-entero-pancreatic neuroendocrine tumors. The aim of this study is to assess the value of SSA in pancreatic NET (PanNET) ≤ 2 cm.
MATERIALS AND METHODS
We retrospectively collected data from 72 patients with sporadic nonfunctioning G1-G2 PanNETs ≤ 2 cm, which were either treated with somatostatin analogs (n = 31) or underwent active surveillance (n = 41) at our institution.
RESULTS
At a median follow-up of 53.7 months, the median progression-free survival was not reached in the treatment group versus an estimated progression-free survival of 85 months in the control group (hazard ratio, 0.11; P = 0.01), with a rate of progression or death up to 21.9% in the active surveillance group. Additionally, in the group of patients treated with somatostatin analogs, the response rate was 16.1% with 1 complete response.
CONCLUSIONS
Our monocentric experience demonstrated a significant antiproliferative activity of somatostatin analogs in patients with sporadic, nonfunctionating G1-G2 PanNETs ≤ 2-cm delaying tumor progression and distant spread in small lesions that sometimes may reveal unpredictable aggressiveness.
目的
对于直径≤2 cm的无功能散发性G1 - G2级胰腺神经内分泌肿瘤，最佳治疗策略尚不清楚。通常建议进行主动监测。PROMID和CLARINET研究证实了生长抑素类似物（SSA）治疗晚期胃肠胰神经内分泌肿瘤的价值。本研究旨在评估SSA在直径≤2 cm的胰腺神经内分泌肿瘤（PanNET）中的价值。
材料与方法
我们回顾性收集了72例直径≤2 cm的散发性无功能G1 - G2级PanNET患者的数据，这些患者在我们机构接受了生长抑素类似物治疗（n = 31）或进行了主动监测（n = 41）。
结果
中位随访53.7个月时，治疗组未达到中位无进展生存期，而对照组的估计无进展生存期为85个月（风险比，0.11；P = 0.01），主动监测组的进展或死亡率高达21.9%。此外，在接受生长抑素类似物治疗的患者组中，缓解率为16.1%，有1例完全缓解。
结论
我们的单中心经验表明，生长抑素类似物在散发性无功能G1 - G2级、直径≤2 cm的PanNET患者中具有显著的抗增殖活性，可延缓肿瘤进展和小病灶的远处转移，而这些小病灶有时可能具有不可预测的侵袭性。
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