Radiofrequency ablation of neuroendocrine liver metastases
Radiofrequency ablation of neuroendocrine liver metastases
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DOI：
10.1007/s00261-004-0257-5
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发表时间：
2005-07-01
影响因子：
--
通讯作者：
Hellman, R
中科院分区：
文献类型：
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作者：
Elvin, A;Skogseid, B;Hellman, R
源自激素产生细胞的肿瘤具有继发于生物活性物质（即肽或胺）的产生的独特临床特征。这些肿瘤的罕见发生使得很少有医生能够完全熟悉这些肿瘤的诊断以及手术和药物治疗。与这些肿瘤相关的各种各样的临床症状和体征进一步使其临床治疗变得复杂。这些肿瘤也可能不分泌具有临床功能的激素，因此被称为无功能肿瘤。内分泌肿瘤通常是高度分化的，并且比高度恶性的外分泌肿瘤更惰性。显着提高的生存率改变了手术、根治性和姑息性手术的适应症，以及药物治疗的适应症和选择。例如，患有中肠类癌并发生肝转移的患者的预期 5 年生存率约为 50%[1, 2]。过去 15 年中生存率有所提高，反映出新型生物活性药物的开发、内分泌综合征的更好控制、有效抗肿瘤全身疗法的使用增加以及对这些罕见疾病的认识的提高，这有助于早期诊断。在过去的十年中，针对肝转移瘤引入了不同的局部治疗方法，例如经动脉化疗栓塞、射频放射和立体定向放射，这些治疗提供了症状和客观的形态学反应[2]。大量积累的经验表明手术和药物联合治疗转移瘤是成功的[3]。
Tumors derived from hormone-producing cells have unique clinical features secondary to the production of biologically active substances, ie, peptides or amines. The rare occurrence of these tumors allows few physicians to become thoroughly acquainted with the diagnosis and the surgical and medical treatments of these tumors. The wide variety of clinical symptoms and signs associated with these tumors further complicates their clinical management. These tumors may also refrain from secreting clinically functioning hormones and are then denoted nonfunctioning tumors. Endocrine tumors are usually highly differentiated and much more indolent than their highly malignant exocrine counterparts. The considerably better survival rate alters the indications for surgery, radical and palliative, and the indications and choices of medical treatment. For example, the expected 5-year survival rate for a patient with midgut carcinoid disease and liver metastases is approximately 50%[1, 2]. Survival rates have increased in the past 15 years, reflecting the development of novel bioactive drugs, the better control of endocrine syndromes, the increased use of effective antitumoral systemic therapy, and an increased awareness of these rare diseases that contributes to earlier diagnoses. Different local treatments for liver metastases have been introduced in the past decade, such as transarterial chemoembolization, radiofrequency radiation, and stereotactic radiation, which provide symptomatic and objective morphologic responses [2]. There is a vast accumulated experience that indicates the success of a combination of surgical and medical treatments of metastases [3].