Clinical Features of Carcinoid Syndrome and the Use of Somatostatin Analogue in Its Management

Vinik, Aaron I.; Thompson, Norman W.; Eckhäuser, Frederic E.; Moattari, Ali Reza

doi:10.3109/02841868909111212

Cited by 52 publications

(33 citation statements)

References 54 publications

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“…As is the case for other treatment modalities the tumour-reducing effect is limited, with objective tumour responses occurring in only a small percentage of the patients. Although, in our opinion, the improvement in quality-of-life status of the patients outweighed the IFN a-2b-related side effects, a similar symptomatic improvement can be reached with somatostatin analogues almost without side effects (Kvols et al, 1986b;Vinik et al, 1989). However, not all patients resistant to IFN a treatment will benefit from somatostatin treatment and vice versa.…”

Section: Tumour Markersmentioning

confidence: 70%

Recombinant interferon alpha-2b in patients with metastatic apudomas: effect on tumours and tumour markers

Biesma

Willemse²,

Mulder³

et al. 1992

Br J Cancer

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Kvols, 1986a;Moertel et al., 1980). Because of the similar properties, often common chemotherapy protocols are used for the different manifestations of APUD tumours (Kelsen et al., 1982;Kessinger et al., 1983). The most effective regimen for carcinoid tumours appears to be the combination of 5-fluorouracil and streptozotocin (Moertel, 1987) We conducted a trial with recombinant human IFN a-2b administered daily to patients with progressive malignant carcinoid tumours, islet cell tumours and medullary carcinomas of the thyroid. In addition, apart from the urinary 5-hydoxyindoleacetic acid (5-HIAA) level, the significance of platelet serotonin levels, serum or plasma levels of neuronspecific enolase (NSE), and urinary levels of serotonin, catecholamine and histamine as markers for the diagnosis and course of carcinoid tumours was studied during IFN a-2b treatment.Finally, the development of neutralising IFN a-2b antibodies during long-term IFN treatment was studied, since neutralising antibodies can develop during IFN a-2b treatment (Spiegel et al., 1986;Oberg et al., 1989b

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Section: Tumour Markersmentioning

confidence: 70%

Recombinant interferon alpha-2b in patients with metastatic apudomas: effect on tumours and tumour markers

Biesma

Willemse²,

Mulder³

et al. 1992

Br J Cancer

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“…The final maximumdose reached 5,950 |Lig/day; use of such a high dosage of octreotide for carcinoid syndrome has never been reported. Reported side effects of octreotide include fat malabsorption, pain at the injection site, rash, nausea, vomiting, abdominal discomfort, dizziness and headache (4,5,8). In the present patient, fat malabsorption was observed, and the patient complained of pain at the injection site and abdominal discomfort.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival in a Patient with Malignant Carcinoid Treated with High-Dose Octreotide.

Deguchi

Tsukada³

et al. 1994

Intern. Med.

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Octreotide acetate, a long-acting somatostatin analogue, is effective in controlling and markedly reducing the symptoms of carcinoid crisis. Wereport a patient with carcinoid syndrome with prolonged survival for 4.5 years with high dose octreotide therapy and survived for 7.5 years after the first flushing, in spite of episodes of severe carcinoid crisis. Dose escalation was required in order to control carcinoid symptoms, and the final dosage was 5,950 jug/day. Although administration of such a high dosage ofoctreotide has never been reported before, we found that octreotide could be used at this dosage safely without inducing serious side effects, and probably prolonged the patient' s survival. Our experience with this case indicates that octreotide acetate is an effective drug in controlling carcinoid crisis and prolonging survival without serious side effects. (Internal Medicine 33: 100-102, 1994)

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“…Clinical symptoms of carcinoid syndrome include: (i) symptoms affecting the skin (flushing, telangiectasis, pellagra -skin inflammation caused by vitamin PP deficiency, resulting from the use of tryptophan for excessive serotonin production by the neoplasm); (ii) symptoms affecting the gastrointestinal tract (secretory diarrhoea, non-specific or colic abdominal pains); (iii) symptoms affecting the cardiovascular system (tricuspid valve disorders, diseases of the pulmonary trunk, rarely mitral valve and aorta disorders); (iv) symptoms affecting the musculoskeletal system (osteoarticular pains, myopathies) [18,19].…”

Section: Symptoms Of the Hormonally Active Nens Of The Small Intestinmentioning

confidence: 99%

“…Triggering factors include alcohol, spicy foods, emotional stress, and medications (serotonin reuptake inhibitors). Flushing in the case of foregut NENs (atypical form of carcinoid syndrome) is more intensive, with a crimson shade; it lasts longer (as much as a few days), affects the torso and upper limbs, and is often accompanied by lowered blood pressure and lacrimation [18].…”

Section: Symptoms Of the Hormonally Active Nens Of The Small Intestinmentioning

confidence: 99%

“…The leading biotherapy method is treatment with SSA (lanreotide and octreotide), which are indicated for the symptomatic therapy of hormonally active NENs of the small intestine. SSA are the preferred treatment option for carcinoid crisis [18,25]. There are ongoing clinical studies on the use of new SSA (pasireotide) in cases of resistance to the standard treatment of carcinoid syndrome [66].…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

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Nowotwory neuroendokrynne jelita cienkiego i wyrostka robaczkowego — zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

Bolanowski

Bednarczuk²,

Bobek-Billewicz³

et al. 2014

Endokrynologia Polska

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We present revised Polish guidelines regarding the management of patients harbouring neuroendocrine neoplasms (NENs) of the small intestine and appendix. The small intestine, especially the ileum, is the most common origin of these neoplasms. Most of them are well differentiated with slow growth. Rarely, they are less differentiated, growing fast with a poor prognosis. Since symptoms can be atypical, the diagnosis is often accidental. Typical symptoms of carcinoid syndrome occur in less than 10% of patients. The most useful laboratory marker is chromogranin A; 5-hydroxyindoleacetic acid is helpful in the monitoring of carcinoid syndrome. Ultrasound, computed tomography, magnetic resonance imaging, colonoscopy, video capsule endoscopy, balloon enteroscopy and somatostatin receptors scintigraphy are used in the visualisation. A histological report is crucial for the proper diagnostics and therapy of NENs, and it has been extensively described. The treatment of choice is surgery, either radical or palliative. Somatostatin analogues are crucial in the pharmacological treatment of the hormonally active and non-active small intestine NENs and NENs of the appendix. Radioisotope therapy is possible in patients with a good expression of somatostatin receptors. Chemotherapy is not effective in general. Everolimus therapy can be applied in patients with generalised NENs of the small intestine in progression and where there has been a failure or an inability to use other treatment options. Finally, we make recommendations regarding the monitoring of patients with NENs of the small intestine and appendix. (6) w mniej niż 10% przypadków. W diagnostyce laboratoryjnej najbardziej przydatne jest oznaczenie stężenia chromograniny A, badanie stężenia kwasu 5-hydroksyindolooctowego jest pomocne w monitorowaniu zespołu rakowiaka. W obrazowaniu stosuje się ultrasonografię, tomografię komputerową, rezonans magnetyczny, kolonoskopię, wideoendoskopię kapsułkową, enteroskopię dwubalonową, scyntygrafię receptorów somatostatynowych. Szczegółowe badanie histologiczne jest kluczowym dla właściwego rozpoznania i leczenia chorych z NEN jelita cienkiego i wyrostka robaczkowego. Leczeniem z wyboru jest postępowanie chirurgiczne, radykalne lub paliatywne. W leczeniu farmakologicznym czynnych i nieczynnych hormonalnie NEN jelita cienkiego i wyrostka robaczkowego podstawowe znaczenie mają analogi somatostatyny. Terapia radioizotopowa u chorych z dobrą ekspresją receptorów somatostatynowych stanowi kolejną opcję terapeutyczną. Chemioterapia jest na ogół nieskuteczna. U pacjentów z rozsianym NEN jelita cienkiego i progresją choroby oraz nieskutecznością innych metod terapii można zastosować ewerolimus. Przedstawiono także zalecenia odnośnie monitorowania chorych z NEN jelita cienkiego i wyrostka robaczkowego. (Endokrynol Pol 2013; 64 (6): 444-493)

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Clinical Features of Carcinoid Syndrome and the Use of Somatostatin Analogue in Its Management

Cited by 52 publications

References 54 publications

Recombinant interferon alpha-2b in patients with metastatic apudomas: effect on tumours and tumour markers

Recombinant interferon alpha-2b in patients with metastatic apudomas: effect on tumours and tumour markers

Long-Term Survival in a Patient with Malignant Carcinoid Treated with High-Dose Octreotide.

Nowotwory neuroendokrynne jelita cienkiego i wyrostka robaczkowego — zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

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