促肾上腺皮质激素分泌型胃肠胰腺和胸椎神经内分泌肿瘤的治疗进展。

IF 4.7 2区 医学 Q2 ONCOLOGY
Marina Tsoli, Anat Bel-Ange, Karine Atlan, Simona Ben-Haim, Gregory Kaltsas, Simona Grozinsky-Glasberg
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引用次数: 0

摘要

观点声明:促肾上腺皮质激素(ACTH)分泌的神经内分泌肿瘤(NENs)是一种罕见但严重的疾病,如果治疗不当,预后不良。治疗策略根据肿瘤的特点和高皮质醇症的严重程度而有所不同。最佳的治疗方法是手术切除NEN,以达到治愈的目的。在不可切除或转移性肿瘤中,建议在现有指南的基础上,医学控制高皮质醇血症并同时治疗NENs。类固醇生成抑制剂是控制高皮质醇症的主要选择,而在严重危及生命的高皮质醇症无法控制的情况下,应考虑双侧肾上腺切除术。此外,在各种抗肿瘤全身治疗方案中,肽受体放射性核素治疗(PRRT)似乎也是控制高皮质醇症的有效选择。预防和治疗皮质醇引起的并发症和合并症对降低发病率和死亡率也很重要。总的来说,促肾上腺皮质激素分泌的NENs的管理可能是非常复杂的,需要在多学科背景下的个体化方法来为患者实现最佳和及时的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Update in the Management of ACTH-Secreting Gastroenteropancreatic and Thoracic Neuroendocrine Neoplasms.

Opinion statement: The adrenocorticotropic hormone (ACTH)-secreting neuroendocrine neoplasms (NENs) represent a rare but frequently severe disease that is associated with poor prognosis, if not adequately managed. Treatment strategies vary according to the characteristics of the tumor and the severity of hypercortisolism. The optimal treatment is surgical resection of the NEN with a curative intent. In unresectable or metastatic tumors, medical control of hypercortisolism with concomitant treatment of NENs based on current guidelines is suggested. Steroidogenesis inhibitors are the principal choice to control hypercortisolism while bilateral adrenalectomy should be considered in cases of failure to control severe life-threatening hypercortisolism. Additionally, amongst the various anti-tumor systemic treatment options, peptide receptor radionuclide therapy (PRRT) seems to also be an effective option for the control of hypercortisolism. Preventive and curative treatment of cortisol-induced complications and comorbidities is also important to reduce morbidity and mortality. Overall, the management of ACTH secreting NENs may be very complex and requires an individualized approach in a multidisciplinary context to achieve the best and timely outcome for the patient.

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来源期刊
CiteScore
7.10
自引率
0.00%
发文量
113
审稿时长
>12 weeks
期刊介绍: This journal aims to review the most important, recently published treatment option advances in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to cancer treatment. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endocrine tumors, lymphomas, neuro-oncology, and cancers of the breast, head and neck, lung, skin, gastrointestinal tract, and genitourinary region. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known oncologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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