Endocrine tumours of the gastrointestinal tract: Chemotherapy.
Malignant neuroendocrine tumours are less sensitive to chemotherapy than other epithelial malignancies. If chemotherapy is considered, tumours of pancreatic origin have a higher sensitivity than tumours from the gastrointestinal tract ('carcinoids'). Chemotherapy with streptozocin combinations and with dacarbazine should be considered in patients with progressive malignant neuroendocrine tumours of the pancreas. A favourable response to chemotherapy can be expected in up to 60% of patients receiving a combination of streptozocin plus doxorubicin, and in up to 40% of patients receiving dacarbazine. A survival benefit has been shown for streptozocin combinations. Treatment regimens are effective in functioning and non-functioning tumours. The response to treatment cannot be predicted. Poorly differentiated neuroendocrine tumours, independent of their origin, respond to a combination of etoposide plus cisplatin. Chemotherapy is, however, almost ineffective in patients with well-differentiated neuroendocrine tumours originating in the gastrointestinal tract ('carcinoids').
Arnold
R
R
Department of Internal Medicine, Division of Gastroenterology and Endocrinology, Philipps University, Baldingerstr, Germany. arnoldr@mailer.uni-marburg.de
Rinke
A
A
Schmidt
Ch
Ch
Hofbauer
L
L
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000473:pathology; D002454:Cell Differentiation; D003606:Dacarbazine / Q000627:therapeutic use; D018450:Disease Progression; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy; D006801:Humans; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013311:Streptozocin / Q000627:therapeutic use*
D000903:Antibiotics, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D013311:Streptozocin; D003606:Dacarbazine