[Carcinoid tumors of the intestines: developments in the Netherlands for diagnosis and palliative treatment].
Carcinoid tumours in the intestine are slowly growing neuroendocrine tumours. Patients as a rule report symptoms of the carcinoid syndrome: attacks of diarrhoea and of flushing. When the earliest symptoms manifest themselves, metastases are already present, virtually always localized in the liver. At a late stage, heart failure may occur, difficult to treat and caused by fibrosis of the tricuspid valve in the presence of protractedly raised blood serotonin levels. To diagnose carcinoid tumours, use is made of radioactive substances binding to hormone receptors such as 131I-MIBG and 111-In-octreotide. When multiple metastases exist, only palliative treatment is possible. The drugs used are the somatostatin analog octreotide, interferon alpha, radioactive MIBG and non-radioactive MIBG; these drugs may also be used in combination. The therapies mentioned have approximately the same effect: symptoms improve in 60-80%, while 30-50% show a biochemical response, i.e. decrease of the number of breakdown products in the urine of the hormones produced by the tumour; tumour size decreases in 0-12%.
Taal
B G
BG
Afd. Gastro-enterologie, Nederlands Kanker Instituut/Antoni van Leeuwenhoek ziekenhuis, Amsterdam.
Hoefnagel
C
C
Boot
H
H
de Jong
D
D
Rutgers
M
M
D002275:Carcinoid Heart Disease / Q000175:diagnosis / Q000209:etiology; D002276:Carcinoid Tumor / Q000150:complications / Q000175:diagnosis* / Q000532:radiotherapy* / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy*; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000556:secondary; D008297:Male; D009377:Multiple Endocrine Neoplasia / Q000175:diagnosis / Q000532:radiotherapy; D009426:Netherlands; D010166:Palliative Care; D019275:Radiopharmaceuticals / Q000627:therapeutic use
D019275:Radiopharmaceuticals