Abstract:

Treatment strategy of pancreatic neuroendocrine neoplasms with liver metastasis        CHEN Luo-hai，CHEN Jie. Department of Gastroenterology，the First Affiliated Hospital of Sun Yat-sen University，Guangzhou 510080，China
Corresponding author: CHEN Jie，E-mail: chen0jie@hotmail.com
Abstract    About 20% to 64% of patients with pancreatic neuroendocrine neoplasms (panNEN) had advanced disease with liver being the most common location of distant metastasis. Liver metastasis is not the contraindication of surgery. Curative resection should still be considered in patients with G1 or G2 disease. In respect of patients with unresectable disease, systematic therapy or nuclide therapy combined with intervention treatment should be applied while liver transplantation can be used only in a small number of selected patients. Temozolomide monotherapy or combined with capecitabine may be effective in patients with well differentiated G3 pancreatic neuroendocrine tumor. As for pancreatic neuroendocrine carcinoma, platinum-based chemotherapy is the first-line treatment option.

Key words: pancreatic neuroendocrine neoplasms, liver metastasis, intervention treatment, chemotherapy

摘要：

20%～64%的胰腺神经内分泌肿瘤病人确诊时即已发生远处转移，肝是其最常见的远处转移部位。肝转移不是手术的禁忌证，对于病理学分级为G1、G2级的病人，应积极考虑根治性切除的可能。对于不能根治性切除的病人应采用全身药物或核素治疗联合介入治疗，肝移植仅在极少数病人中予以考虑。对于高增殖活性胰腺神经内分泌瘤（G3级）肝转移，替莫唑胺单药或联合卡培他滨可能是有效的治疗方案。而对于伴有肝转移的胰腺神经内分泌癌病人，应首选以铂类为基础的全身化疗。

关键词: 胰腺神经内分泌肿瘤, 肝转移, 介入治疗, 化学治疗