MEDIX, God. 19 Br. 107/108  •  Pregledni članak  •  Gastroenterologija/Onkologija HR ENG

Dijagnostika i liječenje neuroendokrinih tumora (NET) probavnoga traktaDiagnosis and treatment of neuroendocrine tumors (NET), gastrointestinal tract

Damir Vrbanec

Neuroendokrini tumori (NET) rijetka su heterogena skupina tumora podrijetlom iz neuroendokrinog sustava crijeva. Ti tumori čine približno 2% svih zloćudnih tumora gastroenteropankreatičnog (GEP) sustava. Posljednje desetljeće svjedoci smo velikih promjena u razumijevanju genetike, klasifikacije i terapijskih mogućnosti u liječenju neuroendokrinih tumora. Prema klasifikaciji Svjetske zdravstvene organizacije GEP-NET-ovi se mogu podijeliti u dobro diferencirane neuroendokrine tumore (NET) i loše diferencirane neuroendokrine karcinome (NEC). Kirurško je liječenje prva terapijska opcija za bolesnike s neuroendokrinim neoplazmama. Za bolesnike koji nisu kandidati za kirurško liječenje terapijske mogućnosti su analozi somatostatina i lokoregionalni zahvati, te za slabo diferencirane karcinome sistemska kemoterapija (streptozocin, doksorubicin, cisplatin, 5-fluorouracil, kapacitabin), odnosno, za dobro diferencirane tumore ciljana biološka terapija (djelovanja na VEGF i mTOR signalne puteve). 

Ključne riječi:
neuroendokrini tumori (NET); neuroendokrini karcinomi (NEC); sistemska terapija; analozi somatostatina

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 19 Br. 107/108

Neuroendocrine tumors (NET) are a rare heterogeneous group of tumors originating in the neuroendocrine system in the intestinal tract. These tumors represent approximately 2% of all malignant tumors of the gastro-enteropancreatic (GEP) system. In the last decade we have witnessed great changes and improvements in our understanding of genetics, classification and treatment options for neuroendocrine tumors. According to the classification of the 2010 WHO (World Health Organization) GEP-NETs are separated into well-differentiated NETs and poorly differentiated neuroendocrine carcinomas (NECs). Surgical treatment is the primary treatment method used in NET patients. For the patients who are not candidates for surgical treatment, they have come up with other therapeutic methods including somatostatin analogues and locoregional procedures, systemic chemotherapy (streptozocin, doxorubicin, platinum-based chemotherapy, 5-fluorouracil, capecitabin) is used for patients with poorly differentiated carcinoma, while well differentiated tumors have targeted biological therapies (acting on VEGF and mTOR-signal pathways). 

Key words:
neuroendocrine carcinoma (NEC); neuroendocrine tumors (NET); somatostatin analogs; systemic therapy