胰腺神经内分泌肿瘤新辅助治疗研究进展

doi:10.3877/cma.j.issn.2095-3232.2024.04.007

胰腺神经内分泌肿瘤（pNENs）是一种高度异质性的肿瘤，手术是唯一可能治愈pNENs的治疗方案，新辅助治疗的开展使部分局部晚期或肝转移患者能够获得再次手术的机会。pNENs新辅助治疗方案主要包括化疗、靶向治疗、生长抑素类似物、肽受体-放射性核素治疗等。在化疗中，CAPTEM方案和基于铂类为主的化疗方案较为常用。生长抑素类似物及肽受体-放射性核素治疗多用于高表达生长抑素受体的个体，靶向治疗主要应用于局部晚期的高分化pNENs。以上治疗方案可以单独应用，也可联用以增强疗效。在治疗方案的选择上，目前尚缺乏高级别循证医学证据，各方案间疗效的比较也缺乏系统性的评价。

关键词: 胰腺神经内分泌肿瘤, 新辅助治疗, 化疗, 靶向治疗, 生长抑素类似物, 肽受体-放射性核素治疗

Pancreatic neuroendocrine neoplasms (pNENs) is a category of highly heterogeneous tumors. Surgery is the only treatment option that offers the potential to cure pNENs. Neoadjuvant therapy enables patients with locally advanced pNENs or liver metastases to obtain the chance of reoperation. Neoadjuvant therapies for pNENs mainly include chemotherapy, targeted therapy, somatostatin analogues, and peptide receptor-radionuclide therapy, etc. CAPTEM regimen and platinum-based chemotherapy regimen are commonly used in chemotherapy. Somatostatin analogues and peptide receptor-radionuclide therapy are primarily given for individuals with high expression of somatostatin receptor. Targeted therapy is mainly delivered for locally advanced well-differentiated pNENs. These regimens can be adopted alone or combined to enhance clinical efficacy. At present, high-level evidence-based medicine evidence is lacking in the selection of treatment regimens, and systematic evaluation is also lacking in comparison of the clinical efficacy among different protocols.

Key words: Pancreatic neuroendocrine neoplasms, Neoadjuvant therapy, Chemotherapy, Targeted therapy, Somatostatin analogues, Peptide receptor-radionuclide therapy

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Research progress in neoadjuvant therapy for pancreatic neuroendocrine neoplasms

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Research progress in neoadjuvant therapy for pancreatic neuroendocrine neoplasms