Somatostatin-receptor imaging of neuroendocrine gastroenteropancreatic tumors

Scherübl, Hans; Bäder, Michael; Fett, U; Hamm, Bernd; Schmidt‐Gayk, H.; Koppenhagen, K; Dop, Fritz-Jan; Riecken, Ernst–Otto; Wiedenmann, Bertram

doi:10.1016/0016-5085(93)91066-q

Cited by 78 publications

(30 citation statements)

References 22 publications

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“…Interestingly, all responders were positive by somatostatin receptor scintigraphy, an imaging procedure detecting somatostatin receptors in vivo [27, 28]. The 2 receptor-negative patients were, on the other hand, in the group of nonresponders.…”

Section: Discussionmentioning

confidence: 99%

Ultra-High-Dose Lanreotide Treatment in Patients with Metastatic Neuroendocrine Gastroenteropancreatic Tumors

Faiss¹,

et al. 1999

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Background: Symptomatic control and occasionally even tumor regression of functional neuroendocrine tumors (NET) of the gastroenteropancreatic (GEP) system can be achieved by somatostatin analogues. Assuming a dose-dependent antiproliferative effect of somatostatin analogues, we performed a study with the somatostatin analogue lanreotide in ultra-high dosages in patients with progressive, metastatic GEP NET. Patients and Methods: 30 patients with metastatic GEP NET, progressive during treatment with somatostatin analogues (≤1.5 mg/day) and/or interferon-α, underwent ultra-high-dose lanreotide therapy (5 mg lanreotide s.c. three times a day). Tumor growth was evaluated every 3 months. Serum chromogranin A, serum serotonin as well as urinary 5-hydroxyindoleacetic acetic acid levels were also determined at 3-month intervals. In patients with functional tumors, tumor-related symptoms were documented. Results: After a 1-year treatment period with ultra-high-dose lanreotide, 1 complete and 1 partial remission were observed in patients with functional midgut NET. Eleven patients had stable disease and 11 patients showed continuing tumor growth after 3–12 months of treatment. Symptoms decreased significantly during therapy. Conclusions: Our data show that ultra-high-dose lanreotide treatment in patients with metastatic GEP NET can lead to control of both symptoms and proliferation in at least some patients refractory to conventional therapies.

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Section: Discussionmentioning

confidence: 99%

Ultra-High-Dose Lanreotide Treatment in Patients with Metastatic Neuroendocrine Gastroenteropancreatic Tumors

Faiss¹,

et al. 1999

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“…Liver uptake was calculated from the anterior view, whereas uptakes of the spleen and kidneys were calculated from the posterior view. This technique has previously been described in detail [14, 15]. …”

Section: Methodsmentioning

confidence: 99%

Endoscopic Ultrasonography of Neuroendocrine Tumours

et al. 2000

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Neuroendocrine tumours (NETs) of the upper gastrointestinal tract are mainly located in the pancreas, stomach or duodenum. The aims of preoperative work-up are the localization of primary tumour(s), determination of local tumour invasion, of lymph node metastases and of the hormones secreted by the tumour. Endoscopic ultrasonography (EUS) offers ideal conditions to localize and stage NETs of the foregut. We report our results in localizing and staging NETs of the foregut in 40 patients examined between 1990 and 1997 by EUS, somatostatin receptor scintigraphy (SRS), computed tomography (CT), magnetic resonance imaging (MRI) and transabdominal ultrasound (US). EUS shows the highest sensitivity in localizing insulinomas compared with SRS, US, CT and MRI. US and EUS should be the first-line diagnostics if insulinoma has been proven by a fasting test. Further diagnostic procedures are unnecessary in most cases. Further diagnostics such as CT or MRI to search for distant metastases are necessary in large tumours or local invasive tumours. EUS shows the highest accuracy to detect or exclude pancreatic gastrinomas, but fails to detect extrapancreatic gastrinomas in about 50%. The combination of EUS and SRS gives additional information. First-line diagnostics in gastrinoma patients should be SRS and CT or MRI. If no metastases are detected, EUS should be the next preoperative imaging procedure. In nonfunctional NETs, EUS provides the best information on local tumor invasion and regional lymph node involvement.

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“…The reasons for that are not completely illucidated. Obviously, somatostatin receptors are only present in 50% of insulinomas, whereas expression of somatostatin receptors has been shown in up to 90% of patients with other GEP tumors [22,23], Similar to diazoxide, the potency of somatostatin and its long-acting analogues seems to depend on the presence of typical beta-granules, whereas tumors with atypical granules or agranular tumors reveal a reduced or virtually no response [24], Octreotide could in the latter group of patients even aggravate hypo glycemic symptoms by suppressing the counter-regulatory principle glucagon. Therefore, insulinoma patients have to be monitored very carefully if long-acting somatostatin analogues are considered for preventing hypoglycemia.…”

Section: Insulinomamentioning

confidence: 99%

Management of Gastroenteropancreatic Endocrine Tumors: The Place of Somatostatin Analogues

Arnold

Frank²,

Kajdan³

1994

Digestion

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The place of the long-acting somatostatin analogue octreotide in the management of symptoms in patients with functional gastroenteropancreatic (GEP) tumors and of growth in patients with metastatic disease is reviewed in this report. Numerous studies indicate that octreotide is, currently, the therapeutic principle of first choice in the symptomatic treatment of patients with carcinoid syndrome, Verner-Morrison syndrome and glucagonoma syndrome but not of insulinoma and gastrinoma patients. A beneficial effect on tumor growth has been demonstrated in 40% of patients with metastatic GEP tumors with stabilization of the disease as the most favorable response. However, further studies have to identify subgroups of patients in whom octreotide alone or in combination with alpha-interferon inhibits tumor growth.

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Somatostatin-receptor imaging of neuroendocrine gastroenteropancreatic tumors

Cited by 78 publications

References 22 publications

Ultra-High-Dose Lanreotide Treatment in Patients with Metastatic Neuroendocrine Gastroenteropancreatic Tumors

Ultra-High-Dose Lanreotide Treatment in Patients with Metastatic Neuroendocrine Gastroenteropancreatic Tumors

Endoscopic Ultrasonography of Neuroendocrine Tumours

Management of Gastroenteropancreatic Endocrine Tumors: The Place of Somatostatin Analogues

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