tailieunhanh - Báo cáo y học: " Evolving Diagnostic and Treatment Strategies for Pancreatic Neuroendocrine Tumors"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Evolving Diagnostic and Treatment Strategies for Pancreatic Neuroendocrine Tumors. | Kulke et al. Journal of Hematology Oncology 2011 4 29 http content 4 1 29 JOURNAL OF HEMATOLOGY ONCOLOGY REVIEW Open Access Evolving Diagnostic and Treatment Strategies for Pancreatic Neuroendocrine Tumors l attHc . a I I IZ1 11 Izcn 11 h a n n a Rdaaloll2 I ara kS Oilc3 ao Pjr-I K4 tmaa Poimmidr5 A la al .ViAíÁC Vua6 iviannew H Kulke Johanna Bendell Ldliy Kvols Joel Picus Rodney rummicl dĩ Id James lao Abstract Pancreatic neuroendocrine tumors NET have diverse clinical presentations. Patients with symptoms of hormone secretion may require specific medical interventions to control those symptoms prior to antitumor intervention. In some patients tumors in the pancreas may be occult and specialized diagnostic imaging or surgery may be required for diagnosis. Other patients may present with more advanced disease presenting with symptoms of tumor bulk rather than hormone secretion. Treatment options for patients with advanced pancreatic neuroendocrine tumors include surgical resection and hepatic directed therapies including partial hepatectomy hepatic artery embolization or other ablative techniques. Streptozocin or temozolomide-based chemotherapy regimens are active against pancreatic NET and can also play an important role in the palliation of patients with advanced disease. A number of biologically targeted agents targeting the VEGF and mTOR signaling pathways have recently shown promise with recent trials showing treatment with the VEGFR tyrosine kinase inhibitor sunitinib or the mTOR inhibitor everolimus improves progression-free survival in patients with advanced NET. Introduction Pancreatic neuroendocrine tumors NET have been considered rare with an estimated incidence of less than 1 per 100 000 individuals 1 . In recent years however the diagnosed incidence of pancreatic NET has increased an observation that is likely due at least in part to improved detection and classification 2 . The diverse and sometimes non-specific clinical syndromes .