A single-centre experience with octreotide in the treatment of different hypersecretory syndromes in patients with functional gastroenteropancreatic neuroendocrine tumors

Cigrovski Berković, Maja and Altabas, Velimir and Herman, Davorka and Hrabar, Davor and Goldoni, Vesna and Vizner, Branka and Zjačić-Rotkvić, Vanja (2007) A single-centre experience with octreotide in the treatment of different hypersecretory syndromes in patients with functional gastroenteropancreatic neuroendocrine tumors. Collegium Antropologicum, 31 (2). pp. 531-534. ISSN 0350-6134

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Abstract

The aim of this research was to assess the clinical and biochemical efficacy of the octreotide in the treatment of patients with various functional gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The study included 14 patients treated with octreotide for 6 months. They were diagnosed with VIPoma, glucagonoma, gastrinoma, medullary thyroid carcinoma (solitary and as a part of MEN-II syndrome), pancreatic carcinoids (solitary and as a part of multiple endocrine neoplasia type-1 syndrome-MEN-1 syndrome) and midgut carcinoids. The patients presented with Verner-Morrison, glucagonoma, Zollinger Ellison and carcinoid syndrome respectively. All had a metastatic disease at the time of diagnosis and a positive octreoscan finding. Initially elevated chromogranin A (CgA) levels were detected in 11 (78.6%) and elevated 5-hydroxyindolacetic acid (5-HIAA) levels in 8 (57.1%) patients. Symptomatic efficacy assessments were made by diarrhea reductions during treatment course, and laboratory efficacy was assessed through changes in 5-HIAA and CgA levels. Assessments were made initially and following 6 months of therapy. Median urinary 5-HIAA and the number of stools decreased significantly (p = 0.016 and p = 0.009 respectively, p < 0.05) while CgA levels had the decreasing tendency but not statistically significant (p = 0.14). There was a positive correlation between the 5-HIAA reduction and the decrease in stool number at baseline and during treatment course (p < 0.05). No correlation was observed between 5-HIAA and CgA levels and also there was no correlation between CgA reduction and symptomatic improvement. The results prove octreotide to be effective in reducing symptoms and biochemical markers associated with hypersecretory syndromes of GEP-NETs.

Abstract in Croatian

Cilj ovog istraživanja bila je procjena kliničke i biokemijske učinkovitosti oktreotida primijenjenog u liječenju bolesnika s različitim funkcionalnim neuroendokrinim tumorima probavnog sustava i gušterače (GEP-NET). U ispitivanje je bilo uključeno 14 bolesnika liječenih zbog VIPoma, glukagonoma, gastrinoma, medularnog karcinoma štitnjače, karcinoida gušterače te karcinoida embriogenetskog podrijetla srednjeg crijeva. Pacijenti su praćeni tijekom 6 mjeseci, a klinički su se prezentirali Verner-Morrisonovim, Zollinger-Ellisonovim, karcinoidnim te sindromom suviška glukagona. U trenutku postavljanja dijagnoze svi su bolesnici imali proširenu bolest te je kod svih bio pozitivan nalaz oktreoscana. Inicijalno povišene vrijednosti kromogranina A (CgA) nađene su u 11 (78.6%), a 5-HIAA u 8 (57.1%) bolesnika. Simptomatski učinak procjenjivan je redukcijom broja stolica, a biokemijski učinak kroz promijene u razini serumskih vrijednosti CgA i 5-HIAA u 24-satnom urinu na početku liječenja te šest mjeseci trajanja terapije oktreotidom. Na kraju ispitivanja došlo je do značajne redukcije vrijednosti 5-HIAA i broja stolica (p=0.016 i p=0.009), dok je kod CgA primijećena regresivna dinamika, no bez statističke značajnosti (p=0.14). Zamijećena je pozitivna korelacija između redukcije 5-HIAA i smanjenja broja stolica na početku ispitivanja te nakon 6 mjeseci liječenja (p<0.05). Nije zabilježena korelacija između vrijednosti 5-HIAA i CgA kao niti CgA i simptomatskog poboljšanja. Pripravci oktreotida pokazali su se učinkovitim u redukciji simptoma ali i biokemijskih biljega različitih funkcionalnih GEP-NETa.

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