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Locoregional and radioisotopic targeted treatment of neuroendocrine tumours.
Hendlisz, A; Flamen, P; Van den Eynde, M; Borbath, I; Demetter, P; Demolin, G; Pattyn, P; Pauwels, S; Peeters, M; Roeyen, G; Van Cutsemo, E; Van Hootegem, Ph; Van Laethem, J L; Verslype, C; Delaunoit, T.
Afiliación
  • Hendlisz A; Medical Oncology Clinic, Institut Jules Bordet, Brussels, Belgium. alain.hendlisz@bordet.be
Acta Gastroenterol Belg ; 72(1): 44-8, 2009.
Article en En | MEDLINE | ID: mdl-19402371
Gastro-entero-pancreatic neuroendocrine tumours (GEP NET) are a heterogeneous group of proliferative disorders whose management dramatically relies on tumour biology. For well-differentiated, low-proliferative index tumours, locoregional treatment and targeted radioisotopic therapies offer an attractive and seemingly efficient alternative to palliative surgical resections. Lack of well-designed, prospective, randomized multicentric studies hinders a balanced evaluation of available locoregional treatment methods: embolization, chemo-embolization, radio-embolization. According to available datas, all techniques achieve a 50-60% radiological response rate and almost 80% of symptomatic relieve for the patients, while their impact on progression-free and overall survival remains not assessable. Same conclusions can be drawn for radiolabeled targeted therapies like MetaiodoBenzylGuanidine (MIBG) and Peptide Receptor Radionuclide Therapy (PRRT), which, provided that their target is expressed by tumour cells, can deliver therapeutic doses of radiation to neoplastic tissues. 131I-MIBG has been associated with a 50% symptomatic response rate and mainly haematological toxicities. PRRT with 111In-DiethyleneTriamineentaacetic Acid-Octreotide, [90Y-DOTA0-Tyr3]-Octreotide, or [177Lu-DOTA0-Tyr3]-Octreotate seem to alleviate symptoms in 50% of patients and obtain a radiological response in 30-38%. Renal toxicity, partially preventable, is more frequent than previously thought and result in an annual decrease in glomerular function by 4 to 8% per year. Forthcoming research in GEP NET should by a majority be designed in randomized, prospective and multicentric fashion. Locoregional disease trials must focus on clinical outcome differences between embolization techniques (embolization, chemoembolization and radioembolization) and surgery. In disseminated disease, studies should assess radiolabeled targeted therapies efficiency when administered along with and compared to new biological and older chemotherapeutic agents.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Neoplasias Gástricas / Tumores Neuroendocrinos / Neoplasias Intestinales Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Acta Gastroenterol Belg Año: 2009 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Bélgica
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Neoplasias Gástricas / Tumores Neuroendocrinos / Neoplasias Intestinales Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Acta Gastroenterol Belg Año: 2009 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Bélgica