Radio‐frequency ablation for symptom control in a patient with metastatic pancreatic insulinoma

Scott, A. R.; Hinwood, David; Donnelly, Richard

doi:10.1046/j.1365-2265.2002.01506.x

Cited by 26 publications

(10 citation statements)

References 7 publications

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“…Included in the recent literature are reports of the control of the symptoms of the insulinoma hormone-excess state by using: everolimus[•39, 40–46, 170, 171]; tyrosine kinase inhibitor sunitinib[•50]; PRRT[44, 55, 58–60, •61, •76, 170, 172]; liver directed therapies including TACE/TAE[44, 70, 72, •73, 74 75, •76, 172–17444, 70, 172]; RFA and use of ablative treatment(ethanol, microwave of primary/metastases[81, 83–87, •89, 90, 92, •93, 175, •176, 177, 178]; by increasing the dosage of octreotide/Lanreotide in refractory cases[153, 155]; use of cytoreductive surgery[157, 158, 160, 172, 174]; use of 131 I-MIBG[•111] and with pasireotide in octreotide resistant cases[125]. …”

Section: Summary Of Recent Advances In Management Of Specific Hormmentioning

confidence: 99%

Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies

Ito¹,

Lee²,

Jensen³

2016

Expert Opinion on Pharmacotherapy

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Introduction Neuroendocrine tumors(NETs), once thought rare, are increasing in frequency in most countries and receiving increasing-attention. NETs present two-treatment problems. A proportion is functional, hormone-excess-state(F-NET), each of which must be treated. Recently, there are many advances, well-covered in reviews/consensus papers on imaging-NETs;new, novel anti-tumor treatments and understanding their pathogenesis. However, little attention has been paid to advances in the treatment of the hormone-excess-state. These advances are usually reported in case-series, and case-reports with few large studies. In this paper these advances are reviewed. Areas covered Advances in the last 5-years are concentrated on, but a review up to 10-years was performed. PubMed and other databases(Cochrane, etc) were searched for F-NET-syndromes including carcinoid-syndrome, as well as meeting-abstracts on NETs. All advances that controlled hormone-excess-states or facilitated-control were covered. These include new medical-therapies[serotonin-synthesis inhibitors(telotristat), Pasireotide, new agents for treating ACTHomas], increased dosing with conventional therapies(octreotide-LAR, Lanreotide-Autogel), mTor inhibitors(everolimus), Tyrosine-kinase inhibitors(sunitinib), cytoreductive surgery, liver-directed therapies(embolization, chemoembolization, radioembolization, RFA), peptide radio-receptor-therapy(PRRT) and 131I-MIBG, ablation of primary F-NETs. Expert Opinion Although many of the newer therapies controlling the hormone-excess-states in F-NETs are reported in relatively few patients, all the approaches show promise. Their description also generates some controversies/unresolved areas, such as the order of these new treatments, their longterm-efficacy, and effectiveness of combinations which may require large, controlled studies.

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Section: Summary Of Recent Advances In Management Of Specific Hormmentioning

confidence: 99%

Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies

Ito¹,

Lee²,

Jensen³

2016

Expert Opinion on Pharmacotherapy

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“…Insulin can however originate from extrahepatic tumors, and insulinomas respond less frequently to TA(C)E and more often to chemotherapy than carcinoids. Embolization is therefore of limited use, but has controlled symptoms for up to 5 years used in chemotherapy-or octreotide-resistant liver-only disease [93,94]. L-TACE lowered hormone levels in metastatic gastrinoma [95] but not in one case of glucagonoma [91].…”

Section: Metastases Of Endocrine Tumorsmentioning

confidence: 99%

Liver embolizations in oncology: A review

Gunvén

2007

Med Oncol

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Arterial embolization of the liver often temporarily retards the growth of liver tumors which are mainly nourished arterially. The use of degradable agents avoids collateral formation which would prohibit repeat procedures and permit tumor regrowth. The effect of embolizations is largest in small hypervascular lesions, e.g., many hepatocellular or neuroendocrine cancers. Toxic chemicals can be added, chemoembolization, with unproven effects on responses and survival rates. Institutional differences in indications and procedures make evaluation of embolizations difficult. However, intermediate-term survival increases in selected cases of unresectable hepatocellular cancers and hormonal symptoms from neuroendocrine tumors often improve. Scant experience supports embolization for anti-tumoral effects in some pediatric tumors, to control bleeding from ruptured tumors, for symptomatic hemangiomas, and for downstaging of hepatocellular cancers before transplantation.

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“…Ethanol injection treatment was tried successfully for patients with hepatocelluar carcinoma or hepatic metastasis. Scott et al 15 described the successful percutaneous ablation of hepatic metastasis of insulinoma. Jurgensen et al 16 reported successful EUS-guided ablation of pancreatic neuroendocrine tumor by ethanol injection.…”

Section: Eus-guided Ethanol Ablation Of Insuli-nomamentioning

confidence: 99%

EUS-Guided Antitumor Therapy for Pancreatic Tumors

Seo

2010

Gut Liver

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Endoscopic ultrasound (EUS) is a very useful modality for the diagnosis and staging of pancreatic masses. With the advent of EUS-guided fine-needle aspiration technology, this modality has made a tremendous leap from imaging modality to histologic diagnosis and therapeutic intervention. EUS offers high-resolution images of and unparalleled access to the pancreas. After locating the tip of the echoendoscope in the duodenum or stomach, several drugs or local treatment modalities can be delivered directly into the pancreas. EUS-guided ethanol lavage with/without paclitaxel injection has been tested for the treatment of cystic tumors of the pancreas, with complete resolution of cystic tumor being observed in up to 70-80% of patients. Ethanol injection is also performed for the management of solid neuroendocrine tumors of the pancreas. Various type of EUS-guided injection have also been investigated for the treatment of pancreatic cancer. An activated allogenic mixed lymphocyte culture (Cytoimplant) was injected in patients with advanced pancreatic cancer. A replication-deficient adenovirus vector carrying the tumor necrosis factor-alpha gene was also delivered intratumorally by EUS. ONYX-015 is an oncolytic attenuated adenovirus that exhibits replication preferentially in malignant cells, causing cell death, and this has also been injected into pancreatic cancers under EUS guidance. EUS-guided local ablation therapies such as radiofrequency ablation, photodynamic therapy, and brachytherapy are also under investigation. EUS-guided fine-needle injection for various solid or cystic lesions is a rapidly expanding field. This article reviews the various applications of EUS for the treatment of pancreatic tumors.

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Radio‐frequency ablation for symptom control in a patient with metastatic pancreatic insulinoma

Cited by 26 publications

References 7 publications

Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies

Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies

Liver embolizations in oncology: A review

EUS-Guided Antitumor Therapy for Pancreatic Tumors

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