title: Comparison of survival with somatostatin analog and chemotherapy and prognostic factors for treatment in 165 advanced neuroendocrine tumor patients with Ki-67 20% or less.
abstract: The objectives of this study were to compare progression-free survival (PFS) with somatostatin analog (SSA) versus chemotherapy (CTx) in first-line therapy and to determine the patient group in which these treatments were more effective in neuroendocrine tumors (NETs) with a Ki-67 index of 20% or less. Patients who received SSA or CTx and had unresectable locally advanced and metastatic NETs with a Ki-67 index of 20% or less were retrospectively selected from 13 centers in the Turkish database between 2000 and 2015. One hundred and sixty-five patients were enrolled. The median age was 56 years and the male-to-female ratio was 1.09. Seventy-four (45%) patients were of grade 1 NET and 91 (55%) were of grade 2. SSA was given to 104 patients, whereas 61 were treated with CTx. The objective response rate after SSA was 15.4%; another 73.1% had stable disease. The objective response rate after CTx was 36.1%, and 40.9% had stable disease (P=0.008). The median PFS in SSA patients was 21 months (95% confidence interval: 12.4-29.6), and 8 months for CTx (95% confidence interval: 5.5-10.6) (P<0.001). There was no significant difference between PFS of receiving SSA and CTx in pancreatic neuroendocrine tumor (PNET) patients; however, the PFS of receiving SSA was longer in non-PNET patients (P<0.001). SSA was better treatment in advanced NET patients with a Ki-67 index of less than 5%, having a primary resected and a performance status of 0 (P<0.05). SSA may be preferred over CTx in advanced NET patients with low-to-intermediate grade.
authors: aDivision of Medical Oncology, Erciyes University School of Medicine, Kayseri bDivision of Medical Oncology, Marmara University School of Medicine cDivision of Medical Oncology, Kartal Training and Research Hospital, İstanbul dDivision of Medical Oncology, Gaziantep University School of Medicine, Gaziantep eDivision of Medical Oncology, Trakya University School of Medicine, Edirne fDivision of Medical Oncology, Abdurrahman Yurtaslan Training and Research Hospital gDivision of Medical Oncology, Gazi University School of Medicine, Ankara hDivision of Medical Oncology, İzmir Katip Çelebi University School of Medicine, İzmir iDivision of Medical Oncology, Muğla Sitki Koçman University School of Medicine, Muğla jDivision of Medical Oncology, Celal Bayar University School of Medicine, Manisa kDivision of Medical Oncology, Firat University School of Medicine, Elaziğ lDivision of Medical Oncology, Cumhuriyet University School of Medicine, Sivas mDivision of Medical Oncology, Afyon Kocatepe University School of Medicine, Afyon, Turkey.
authors: Ersin
authors: E
authors: Özaslan
authors: Halit
authors: H
authors: Karaca
authors: Sinan
authors: S
authors: Koca
authors: Alper
authors: A
authors: Sevinç
authors: Bekir
authors: B
authors: Hacioğlu
authors: Metin
authors: M
authors: Özkan
authors: Melike
authors: M
authors: Özçelik
authors: Ayşe O
authors: AO
authors: Duran
authors: İlhan
authors: İ
authors: Hacibekiroğlu
authors: Yaşar
authors: Y
authors: Yildiz
authors: Özgür
authors: Ö
authors: Tanriverdi
authors: Serkan
authors: S
authors: Menekşe
authors: Asude
authors: A
authors: Aksoy
authors: Oktay
authors: O
authors: Bozkurt
authors: Semiha
authors: S
authors: Urvay
authors: Mükremin
authors: M
authors: Uysal
authors: Hacer
authors: H
authors: Demir
authors: Aydin
authors: A
authors: Çiltaş
authors: Faysal
authors: F
authors: Dane
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000188:drug therapy* / Q000378:metabolism; D015282:Octreotide / Q000627:therapeutic use; D010456:Peptides, Cyclic / Q000627:therapeutic use; D012189:Retrospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D019394:Ki-67 Antigen; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D015282:Octreotide