gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Case reports: Treatment of progressive, metastatic, non functioning neuroendocrine tumours (NET) with Octreotide

Meeting Abstract

  • corresponding author presenting/speaker Christiane Gog - Klinik für Allgemein-und Gefäßchirurgie, Universitätsklinikum, Frankfurt, Frankfurt am Main, Deutschland
  • Ursula Pession - Klinik für Allgemein-und Gefäßchirurgie, Universitätsklinikum, Frankfurt
  • Christoph Wullstein - Klinik für Allgemein-und Gefäßchirurgie, Universitätsklinikum, Frankfurt
  • Wolf Otto Bechstein - Klinik für Allgemein-und Gefäßchirurgie, Universitätsklinikum, Frankfurt

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPE237

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Veröffentlicht: 20. März 2006

© 2006 Gog et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Octreotide is well established in the treatment of functioning NET. Beside the symptomatic treatment a number of cases of partial tumour regression with octreotide administered with or without other treatment modalities have been reported in the literature [1].

The antiproliferative effect of Octreotide on metastatic NET is still poorly understood and hasn’t been finally evaluated in studies. However this therapy option should be strongly considered in progressive, metastatic, OctreoScan positive NET with and even without clinical symptoms according to the guidelines [2], [3]. Regarding the monitoring of the progression of disease, specially the time intervals of measuring the chromogranin A (CgA) plasma levels, the recommendations are rare and less clear.

Methods: Three patients (two female, one male, median age 59, range 42-72) with poorly differentiated, progressive, metastatic, non functioning, OctreoScan positive NET (two pancreas, one unknown) were treated with Octreotide (diff. dosages, s.c. or monthly i.m.) and sporadically with chemoembolisation (TACE). We measured the plasma CgA levels regularly every 4-6 weeks and conducted a computed tomography (CT) every 3 to 6 month.

Results: The levels of CgA in two patients decreased responding to the treatment with Octreotide and TACE. Increasing CgA could often reduced again with a further TACE with or without a higher dosage of Octreotide. Typical was the following course: 07/2003 CgA 74 U/l, 08/2003 CgA 76 U/l, 09/2003 CgA 71 U/l, 10/2003 CgA 137 U/l, 11/2003 CT: Progress of metastatis, TACE, 12/2003 CT: stable disease, CgA 60 U/l, 01/2004 CgA 76 U/l. CgA values correlated with the progression of the tumour monitored by the CT.

Conclusion: The therapy of Octreotide and TACE seems to have an antiproliferative effect in non functioning NET. This report further demonstrate the importance of a close monitoring of the CgA specially in progressive, metastatic, non functioning NET. From our experience a measurement every 4-6 weeks is practicable and allows to adapt treatment in time.


References

1.
Leong. Journal of Surgical Oncology. 2002;79:180-187.
2.
Leitlinien zur chirurgischen Therapie von NET-GEP. 2002;G96(3).
3.
Öberg K, et al. Ann Oncol. 2004;15(6):966-73.