Vol 7, No 2 (2011)
Review paper
Published online: 2011-06-22
Diagnosis and treatment of patients with endocrine pancreatic cancer, including cases of mixed adenoneuroendocrine origin
Onkol. Prak. Klin 2011;7(2):49-57.
Abstract
Pancreatic neuroendocrine tumours (PNT) belong to the group of gastroenteropancreatic neuroendcorine
tumours (GEP-NET). Pancreatic neuroendocrine tumours are relatively rare tumours, but recently their
incidence has been increasing. Except the mixed adenoneuroendocrine carcinoma, where the exocrine
part is the prognostic factor and also determines the treatment method, PNT have usually better prognosis
than adenocarcinoma of the pancreas. But prognosis depends mainly on the stage of the disease at
the time of diagnosis. Therefore the diagnostic methods — histopathological, immunohistochemical,
biochemical and imaging (both anatomical and metabolic) are still improving. The proper diagnosis
and staging of the disease determine further decisions on therapeutic options. We can observe also the
improvement of treatment methods used in case of PNT. This is visible in the field of use of characteristic klasyfeatures
of neuroendocrine cells such as somatostatin receptors’ expression. Promising are also the
results of clinical trials with new agents — inhibitors of angiogenesis and proliferation of the tumour
cells (targeted therapy) and new schemes of systemic chemotherapy. This development is particularly
important in the cases where the diagnosis is made at the advanced stages of the disease and due to
inoperable primary tumour and/or dissemination of the process surgical treatment is not possible or
the effect of this treatment is worse than expected.
Onkol. Prak. Klin. 2011; 7, 2: 49–57
Onkol. Prak. Klin. 2011; 7, 2: 49–57
Keywords: pancreatic neuroendocrine tumourssomatostatin analoguespeptide receptor radionuclide therapytargeted therapy