Tomassetti P, Migliori M, Gullo L
Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.
Am J Gastroenterol. 1998 Sep;93(9):1468-71. doi: 10.1111/j.1572-0241.1998.465_q.x.
Lanreotide is a somatostatin analogue whose activity persists for 10-14 days. In this study, we treated a group of patients with gastrointestinal endocrine tumors with lanreotide to assess its therapeutic efficacy and tolerability.
Eighteen patients, 12 male and six female, mean age 58 yr (range, 25-80 yr) were studied. Ten had carcinoid tumors, five had nonfunctioning endocrine tumors, two had glucagonomas, and the remaining one had a gastrinoma. All patients had somatostatin receptors, demonstrated by octreoscan scintigraphy. Lanreotide was administered intramuscularly at a dose of 30 mg every 10 days, for a mean of 12 months (range, 5-18 months). Fifteen of the 18 patients had been previously treated with octreotide.
In patients with carcinoid tumors, lanreotide markedly reduced daily bowel movements and flushing episodes. A reduction was also observed in urinary serotonin and urinary 5-hydroxyindoleacetic acid, although it was not statistically significant. A marked reduction in symptoms, and in plasma glucagon and serum gastrin levels, was also observed in patients with glucagonoma and gastrinoma. In the five patients with nonfunctioning endocrine tumors, as in all the other 13 patients, no significant effects were noted in the size of the tumor. The administration of lanreotide did not cause side effects, apart from transient abdominal pain and pain at the injection site in two patients. Only in the patient with gastrinoma was lanreotide suspended, because of the appearance of attacks of marked hypoglycemia. In the 15 patients previously treated with octreotide, no differences in the effects were noted with lanreotide.
Lanreotide has a satisfactory therapeutic efficacy and tolerability in the treatment of gastrointestinal endocrine tumors; its effects are similar to those of octreotide. However, unlike octreotide, it can be administered once every 10-14 days, instead of 2 or 3 times daily and for this reason, it is preferable in clinical practice.
兰瑞肽是一种生长抑素类似物，其活性可持续10 - 14天。在本研究中，我们用兰瑞肽治疗一组胃肠道内分泌肿瘤患者，以评估其治疗效果和耐受性。
研究对象为18例患者，其中男性12例，女性6例，平均年龄58岁（范围25 - 80岁）。10例患有类癌肿瘤，5例患有无功能性内分泌肿瘤，2例患有胰高血糖素瘤，其余1例患有胃泌素瘤。所有患者均经奥曲肽闪烁扫描显示有生长抑素受体。兰瑞肽以每10天30 mg的剂量肌肉注射，平均治疗12个月（范围5 - 18个月）。18例患者中有15例曾接受过奥曲肽治疗。
在类癌肿瘤患者中，兰瑞肽显著减少了每日排便次数和潮红发作次数。尿5 - 羟色胺和尿5 - 羟吲哚乙酸也有所降低，尽管差异无统计学意义。在胰高血糖素瘤和胃泌素瘤患者中，症状、血浆胰高血糖素水平和血清胃泌素水平也显著降低。在5例无功能性内分泌肿瘤患者中，与其他13例患者一样，未观察到肿瘤大小有明显变化。除2例患者出现短暂腹痛和注射部位疼痛外，兰瑞肽的使用未引起副作用。仅胃泌素瘤患者因出现明显低血糖发作而停用兰瑞肽。在15例曾接受奥曲肽治疗的患者中，未观察到兰瑞肽与奥曲肽在疗效上有差异。
兰瑞肽在治疗胃肠道内分泌肿瘤方面具有令人满意的治疗效果和耐受性；其效果与奥曲肽相似。然而，与奥曲肽不同的是，它可以每10 - 14天给药一次，而不是每天2或3次，因此在临床实践中更可取。
