Management of advanced neuroendocrine tumors with hepatic metastasis.

Journal Article (Journal Article;Review)

Neuroendocrine tumors (NETs) in general and specifically these gastroenteropancreatic-neuroendocrine tumors often present a considerable diagnostic and therapeutic challenge, especially those that behave in an aggressive fashion. The majority of tumors are diagnosed at a stage that the only curative treatment, radical surgical intervention, is no longer an option and thus long-term therapy with somatostatin analogs is focused on symptom amelioration and in the improvement of quality of life. Although biotherapy is currently the most efficient treatment to achieve palliation, conventional chemotherapy may have some utility in undifferentiated or highly proliferating neuroendocrine carcinomas and pancreatic NETs. Hepatic metastases, depending on size, location, and number may be amenable to surgical resection or radiofrequency ablation. If surgery is not feasible, embolization either alone (bland), in combination with chemotherapeutic agents, or using radioactive microspheres can be used. Peptide receptor targeted radiotherapy using radiolabeled octapeptide analogs (Yttrium or Lutetium-octreotide) may lead to reduction in tumor size, but in most circumstances has a tumor stabilizing effect. A variety of antiangiogenesis and growth factor-targeted agents have been evaluated, but to date, the results have failed to meet our expectations.

Full Text

Duke Authors

Cited Authors

  • Khasraw, M; Gill, A; Harrington, T; Pavlakis, N; Modlin, I

Published Date

  • October 2009

Published In

Volume / Issue

  • 43 / 9

Start / End Page

  • 838 - 847

PubMed ID

  • 19654558

Electronic International Standard Serial Number (EISSN)

  • 1539-2031

Digital Object Identifier (DOI)

  • 10.1097/MCG.0b013e3181b152a1


  • eng

Conference Location

  • United States