ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

Akerstr&ouml;m, G&ouml;ran; Falconi, Massimo; Kianmanesh, Réza; Ruszniewski, Philippe; Pl&ouml;ckinger, Ursula

doi:10.1159/000225949

Cited by 37 publications

(13 citation statements)

References 40 publications

(52 reference statements)

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“…Systemic manifestations vary depending on the embryological origin of the primary tumor and the extension or site of metastasis [5, 6]. This occurs in approximately 20 to 30% of patients with carcinoid tumors with hepatic metastasis [7]. …”

Section: Discussionmentioning

confidence: 99%

Reversible Right-Sided Heart Failure Secondary to Carcinoid Crisis

Herrera

Restrepo

Díaz

et al. 2013

Case Reports in Critical Care

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Carcinoid crisis is an infrequent and little-described complication of neuroendocrine tumors that can be life threatening. It may develop during induction of anesthesia, intraoperatively, during tumor manipulation and arterial embolization, or even spontaneously. The massive release of neuroendocrine substances can lead to potentially fatal complications. Somatostatin analogs inhibit the release of these substances and are the mainstay of treatment. The following case report describes a patient with reversible acute right-sided heart failure posterior to hepatic artery embolization.

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Section: Discussionmentioning

confidence: 99%

Reversible Right-Sided Heart Failure Secondary to Carcinoid Crisis

Herrera

Restrepo

Díaz

et al. 2013

Case Reports in Critical Care

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“…glucocorticoids should be administered. For postoperative pain, epidural analgesia is preferred [58, 59]. …”

Section: Pre- and Peri-intervention Strategiesmentioning

confidence: 99%

Management of the hormonal syndrome of neuroendocrine tumors

Gut

Waligórska‐Stachura

Czarnywojtek

et al. 2017

aoms

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Gastroenteropancreatic neuroendocrine tumors (GEP/NET) are unusual and rare neoplasms that present many clinical challenges. They characteristically synthesize store and secrete a variety of peptides and neuroamines which can lead to the development of distinct clinical syndrome, however many are clinically silent until late presentation with mass effects. Management strategies include surgery cure and cytoreduction with the use of somatostatin analogues. Somatostatin have a broad range of biological actions that include inhibition of exocrine and endocrine secretions, gut motility, cell proliferation, cell survival and angiogenesis. Five somatostatin receptors (SSTR1-SSTR5) have been cloned and characterized. Somatostatin analogues include octreotide and lanreotide are effective medical tools in the treatment and present selectivity for SSTR2 and SSTR5. During treatment is seen disapperance of flushing, normalization of bowel movements and reduction of serotonin and 5-hydroxyindole acetic acid (5-HIAA) secretion. Telotristat represents a novel approach by specifically inhibiting serotonin synthesis and as such, is a promising potential new treatment for patients with carcinoid syndrome. To pancreatic functionig neuroendocrine tumors belongs insulinoma, gastrinoma, glucagonoma and VIP-oma. Medical management in patients with insulinoma include diazoxide which suppresses insulin release. Also mTOR inhibitors may inhibit insulin secretion. Treatment of gastrinoma include both proton pump inhibitors (PPIs) and histamine H2 – receptor antagonists. In patients with glucagonomas hyperglycaemia can be controlled using insulin and oral blood glucose lowering drugs. In malignant glucagonomas smatostatin analogues are effective in controlling necrolytic migratory erythemia. Severe cases of the VIP-oma syndrome require supplementation of fluid losses. Octreotide reduce tumoral VIP secretion and control secretory diarrhoea.

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“…A műtét során fellépő bronchospasmus esetén béta-receptor-agonista és theophyllinszármazékok adása tilos; ilyen esetekben kiegészítő octreotid, valamint glüko-kortikoid adása javasolt [39]. Vazopresszor aminok és vazopresszin a tumorból történő hirtelen szerotoninkiáramlást indukálhatnak, ezért ezeknek a szereknek az adása csak szomatosztatinanalóggal előkezelt beteg esetében javasolt [40].…”

Section: Carcinoid Szindróma éS Carcinoid Krízis Kezeléseunclassified

Medical treatment of neuroendocrine tumours

Tóth

2013

Orvosi Hetilap

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A szerző áttekinti a neuroendokrin daganatoknak az utóbbi években jelentősen kibővült gyógyszeres kezelési lehetőségeit. Tárgyalja azokat a legfontosabb szempontokat, amelyeket a gyógyszeres kezelési terv kialakításakor fi gyelembe kell venni. Gyógyszeres kezelést rendszerint az előrehaladott stádiumú daganatoknál, valamint a hormontúl-termeléssel járó esetekben alkalmaznak. A szomatosztatinanalógokkal 25 éve kezelik a hormontúltermelő daganatos, köztük a carcinoid szindrómás betegeket. Egyre több bizonyíték van arra is, hogy a szomatosztatinanalógok daganatellenes hatással is bírnak, különösen a vékonybél-eredetű, valamint feltételezhetően a pancreaskiindulású jól differenciált (G1/G2) daganatok esetében. Csaknem azonos az indikációs területe az interferonoknak. Jól meghatároz-ható esetekben a citosztatikus kemoterápiának változatlanul helye van ezeknek a daganatoknak a kezelésében. A G1/ G2 fokozatú, progresszív pancreas neuroendokrin daganatok esetében streptozotocin-és újabban temozolomidalapú kemoterápia alkalmazható. A G3 neuroendokrin carcinomákban ciszplatin-etopozid kombináció javasolt. A közel-múltban két új célzott gyógyszert, az emlős rapamycin célpont everolimust és a kombinált tirozinkináz-gátló sunitinibet törzskönyvezték a G1/G2 pancreas neuroendokrin daganatok kezelésére. A szerző összegzi a legújabb gyógy-szeres kezelési ajánlásokat és algoritmusokat. Röviden bemutatja azokat a fejlesztés alatt álló molekulákat, amelyek további reményt nyújtanak a neuroendokrin daganatok kezelésében. Orv. Hetil., 2013, 154, 1556-1564 Kulcsszavak: neuroendokrin daganatok, szomatosztatinanalógok, célzott kezelés, gyógyszerterápia megválasztása Medical treatment of neuroendocrine tumoursThe author aims to review the established medical treatment options of neuroendocrine tumours, which have expanded greatly in recent years and present the most important aspects to be considered in planning patients' management. Medical treatment is usually considered in advanced stages of these tumours, as well as in cases of hormone overproduction. Somatostatin analogues have been known to be effective in alleviating hormone excess syndromes, especially carcinoid syndrome for the past 25 years. There is a convincing evidence that the somatostatin analogue octreotide is useful as an antitumor agent, at least in well-differentiated small intestinal neuroendocrine tumours and probably also in those of pancreatic origin. Interferons may be also used and the indications for their use may be almost the same. Optimal patient selection is mandatory for the use of cytotoxic chemotherapy. Streptozotocin-and, recently, temozolomide-based chemotherapies should be considered in progressive phases of well differentiated (G1/G2) pancreatic neuroendocrine tumours. A cisplatin-etoposide combination is the fi rst choice for the treatment of G3 neuroendocrine carcinomas of any origin. Recently, the mammalian target of rapamycin inhibitor everolimus and the combined tyrosine kinase inhibitor sunitinib were registered for the treatment of G1/G2 pancr...

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ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

Cited by 37 publications

References 40 publications

Reversible Right-Sided Heart Failure Secondary to Carcinoid Crisis

Reversible Right-Sided Heart Failure Secondary to Carcinoid Crisis

Management of the hormonal syndrome of neuroendocrine tumors

Medical treatment of neuroendocrine tumours

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