晚期胃肠神经内分泌肿瘤综合治疗

Multidisciplinary approach on the management of patients with advanced gastrointestinal neuroendocrine tumors

胃肠神经内分泌肿瘤(neuroerdocrine neoplasms,NENs)包括神经内分泌瘤(NET G1、G2)和神经内分泌癌(NEC G3)。诊断时多数为转移性晚期NENs。晚期胃肠NECG3病人进展快预后差,治疗主要是含铂方案为基础化疗。而晚期胃肠NENs治疗手段包括手术、药物、局部消融(或局部介入)和多肽靶向放射治疗。晚期中肠NET不选择化疗,生长抑素类似物是晚期胃肠NET首选治疗药物。

The terminology of tile new WHO classification of gastrointestinal neuroendocrine neoplasms （NENs） includes neuroendocine tumors （NET G1/G2） and neuroendocrine eancinoma（NEC G3）. Gastrointestinal NENs are frequently metastatic at the time of initial diagnosis. Poorly-differentiated gastrointestinal NECs have a rapidly progressive clinical course and a poor prognosis. They are generally treated with platinum-based chemotherapy regimens. Therapeutic approaches for management of advanced gastrointestinal NENs include surgical, medical, local ablative/loeoregional procedure and nuclear medicine strategies. Cytotoxics are not considered when the primary location is in the midgut. The initiating medical therapy with a somatostatin analog for advanced gastrointestinal NET patients is standard therapy.