Treatment of Insulinomas with Minimally Invasive Physical Procedure. Literature Review

Abstract

Insulinoma is the most common functioning pancreatic neuroendocrine tumor with the development of the organic hyperinsulinism and the severe hypoglycemia. Insulinoma can be treated radically only by surgical removal. In cases when the surgery may cause severe complications with the high risk of mortality, the physical non-surgical methods can be used. The world literature review using PubMed, MedScape, and Cochrane databases was performed. Keywords Binsulinoma^+ Bphysical methods^were used including every type of the method. One hundred fifty-two articles in English devoted to different physical methods of treatment of neuroendocrine tumors were found. Twenty-seven papers with the description of the minimally invasive treatment of insulinomas were found among them. There were data about the different methods revealed such as radiofrequency ablation, microwave ablation, cryodestruction, laser ablation, irreversible electroporation, photodynamic therapy, high-intensity focused ultrasound, Cyberknife, and tumor alcoholization. Literature search showed that there are a few papers about the description of the self-experience of each method, but there are no papers with the full compartment of advantages and disadvantages of each method of treatment. Each method was used because of its availability in the hospital or department. Contemporary statement of the physical mini-invasive method of insulinomas treatment requires investigations with the full randomized trials. These researches can identify the points to use one or another physical method and to choose the most right way to treat patients with hormonal-producing pancreatic neuroendocrine tumors.

Curative treatment of pancreatic functioning insulinoma with stereotactic ablative radiation therapy: case report

“…Each method was used because of its availability in the hospital or department. 15 No full head-to-head comparison of different methods.…”

“…22 Kong was the first to use Cyberknife for pancreatic cancer treatment with increased body mass were observed in 100% of cases. 15,23 Phase I/II studies have demonstrated that CyberKnife radiosurgery is a safe and effective strategy for management of patients with locally advanced and metastatic pancreatic cancer. No significant toxicities were observed during or after treatment providing proof of concept that SBRT is an effective therapeutic strategy for functional neuroendocrine neoplasms.…”