Efficient symptomatic control of carcinoid tumors with somatostatin in patients with disease progression under alpha-interferon therapy.
OBJECTIVE
We report--as a retrospective observation--on eight patients with malignant carcinoid tumors.


METHODS
All patients were initially treated with alpha-interferon and received the longacting somatostatin analogue octreotide (SMS 201-995) after disease progression. Tumor growth was monitored by CT-scan or ultrasound. In addition, serum CgA and urinary 5-HIAA values were determined.


RESULTS
All patients responded with relief of symptoms within a few days after the start of octreotide therapy. A regression of the tumor size did not occur, however four patients showed no significant progress over a period of nine to more than eighteen months. The endocrine parameter chromogranin A--determined by immunoluminometric assay (ILMA)--was elevated in all eight patients regardless of symptoms and showed a close correlation with the course of disease. The urinary 5-HIAA values were only elevated in seven patients. In addition, 123I-SMS 204-090 scintigraphy could be performed in six patients. Using this method most of the primary tumors and metastases could be detected.


CONCLUSIONS
Only octreotide therapy showed a sufficient symptomatic control and has to be considered as progress in drug therapy for patients with malignant carcinoid tumors. In addition, chromogranin A is an interesting endocrine parameter for the follow-up of the secretory activity.
Boehme
M W
MW
Dept. of Internal Medicine IV, University of Heidelberg, Germany.
Schmidt-Gayk
H
H
Bihl
H
H
Eisenhut
M
M
Herfarth
C H
CH
Kommere
B
B
Raeth
U
U
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D053379:Chromogranin A; D002864:Chromogranins; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D006897:Hydroxyindoleacetic Acid; D015282:Octreotide