Article information
El gastrinoma es un tumor secretor de gastrina y es el segundo pancreático más frecuente, pudiendo presentarse como esporádico o como parte de la neoplasia endocrina múltiple tipo 1 (MEN1). Las manifestaciones clínicas se deben a la elevación de gastrina y a la hipersecreción ácida, excepto por los síntomas derivados de las metástasis. La confirmación de la hipergastrinemia y de los marcadores tumorales ofrece gran sensibilidad para el diagnóstico. Las nuevas técnicas de imagen, como la ecografía endoscópica, la resonancia magnética y, particularmente, la gammagrafía con análogos de somatostatina, permiten un mejor acercamiento a la localización. El tratamiento exitoso de la enfermedad diseminada requiere un equipo multidisciplinario; la eliminación quirúrgica radical del tumor puede ser curativa, aunque raramente es posible. La bioterapia con análogos de somatostatina (ya conocidos o nuevos) o el interferón se aconseja en tumores bien diferenciados, ya que la quimioterapia se reserva para los pobremente diferenciados y progresivos. La terapia con radionúclidos debe utilizarse en tumores con captación de radiotrazador, tanto tras la cirugía para erradicar la enfermedad residual como si ocurre fallo de la terapia convencional o la bioterapia. El mantenimiento de la calidad de vida deber ser la prioridad, particularmente porque los pacientes con enfermedad diseminada pueden tener una supervivencia prolongada.
Palabras clave:
Gastrinoma
Síndrome de Zollinger-Ellison
Análogos de somatostatina
Octreótida
Gastrinoma is a gastrin-secreting tumor and is the second most frequent neoplasm of the pancreas. This tumor can occur either sporadically or in association with MEN-1. Except for the symptoms due to the effects of widespread metastases, clinical manifestations are due to elevated gastrin levels and hypersecretion of gastric acid. Confirmation of hypergastrinemia and tumoral markers provide high sensitivity in diagnosis. New imaging techniques include endoscopic ultrasonography, magnetic resonance imaging, and especially, somatostatin analog scintigraphy, which allow a better approach to the location of the tumor.
Successful treatment of disseminated disease requires a multidisciplinary team; radical surgery may be curative but is rarely feasible. Biotherapy with classical or new somatostatin analogs, or interferon, is recommended for well-differentiated tumors, since chemotherapy is reserved for poorly differentiated and progressive tumors.
Radionucleotide therapy should be used for tumors exhibiting radiotracer uptake, either after surgery to eradicate microscopic residual disease or subsequently if conventional treatment or biotherapy fail. The priority should be to maintain quality of life, particularly because patients with disseminated disease may have prolonged survival.
Key words:
Gastrinoma
Zollinger-Ellison syndrome
Somatostatin analogs
Octreotide
Full text is only aviable in PDF
Bibliografía
[1.]
R.M. Zollinger, E.H. Ellison.
Primary peptic ulceration of the jejunum associated with islet cell tumours of the pancreas.
Ann Surg., 42 (1955), pp. 709
[2.]
U. Plockinger, G. Rindi, R. Arnold, B. Eriksson, E.P. Krenning, W.W. de Herder.
Guidelines for the diagnosis and treatment of neuroendocrine gastrointestinal tumours.
Neuroendocrinology, 80 (2004), pp. 394424
[3.]
E.H. Ellison, S.D. Wilson.
The Zollinger-Ellison syndrome: reaprasial and evaluation of 260 registred cases.
Ann Surg., 160 (1964), pp. 512
[4.]
P.K. Roy, D.J. Venzon, H. Shojamanesh, A. Abou-Saif.
Zollinger-Ellison syndrome. Clinical presentation in 261 patients.
Medicine., 79 (2000), pp. 379-411
[5.]
Del Valle J, Scheiman J. Zollinger-Ellison syndrome. En: Yamada, editor. Manual of gastroenterology. 4th ed. p.1377-91.
[6.]
A. Tartaglia, S. Bianchini, P. Vezzadini.
Biochemical diagnosis of gastroenteropancreatic endocrine tumors.
Minerva Med., (2003), pp. 941-947
[7.]
P.K. Roy, D.J. Venzon, K.M. Feigenbaum, P.D. Koviack.
Gastric secretion in Zollinger-Ellison syndrome. Correlation with clinical expression, tumor extent and role in diagnosis-a prospective NIH study of 235 patients and a review of 984 cases in the literature.
Medicine, 80 (2001), pp. 222
[8.]
G.A. Kaltas, G.M. Besser, A.B. Grossman.
The diagnosis and medical manegement of advanced neuroendocrine tumors.
Endocr Rev., 25 (2004), pp. 458-511
[9.]
D. Kwekkeboom, E.P. Krenning, M. De Jong.
Peptide receptor imaging and therapy.
J Nucl Med., 41 (2000), pp. 1704-1713
[10.]
S.W. Lamberts, A.J. Van der Lely, W.W. De Herder, L.J. Hofland.
Octreotide.
N Engl J Med., 334 (1994), pp. 246-254
[11.]
K. Sharma, Y.C. Patel, C.B. Srikant.
C-terminal region of human somatostatin receptor 5 is required for induction of Rb and G1 cell cycle arrest.
Mol Endocrinol., 13 (1999), pp. 82-90
[12.]
E.P. Krenning, W.H. Bakker, W.A. Breeman, J.W. Koper, P.P. Kooij, L. Ausema, et al.
Localization of endocrine-related tumours with radioiodinated analogue of somatostatin.
Lancet, 1 (1989), pp. 242-244
[13.]
E.P. Krenning, M. De Jong, P.P. Kooij, W.A. Breeman, W.H. Bakker, W.W. De Herder, et al.
Radiolabelled somatostatin analogue(s) for peptide receptor scintigraphy and radionuclide therapy.
Ann Oncol., 10 (1999), pp. S23-S29
[14.]
A. Otte, J. Mueller-Brand, S. Dellas, E.U. Nitzsche, R. Herrmann, H.R. Maecke.
Yttrium-90-labelled somatostatin-analogue for cancer treatment.
Lancet, 351 (1998), pp. 417-418
[15.]
W.A. Breeman, D.J. Kwekkeboom, P.P. Kooij, W.H. Bakker, L.J. Hofland, T.J. Visser, et al.
Effect of dose and specific activity on tissue distribution of indium-111-pentetreotide in rats.
J Nucl Med., 36 (1995), pp. 623-627
[16.]
H.R. Balon, S.J. Goldsmith, B.A. Siegel, E.B. Silberstein, E.P. Krenning, O. Lang, et al.
Procedure guideline for somatostatin receptor scintigraphy with (111) In-pentetreotide.
J Nucl Med., 42 (2000), pp. 1134-1138
[17.]
U. Dorr, U. Rath, M.L. Sautter-Bihl, G. Guzman, D. Bach, H.J. Adrian, et al.
Improved visualization of carcinoid liver metastases by indium-111 pentetreotide scintigraphy following treatment with cold somatostatin analogue.
Eur J Nucl Med., 20 (1993), pp. 431-433
[18.]
G.A. Kaltsas, J.J. Mukherjee, A.B. Grossman.
The value of radiolabelled MIBG and octreotide in the diagnosis and management of neuroendocrine tumours.
Ann Oncol., 12 (2001), pp. S47-50
[19.]
E.P. Krenning, D.J. Kwekkeboom, W.H. Bakker, W.A. Breeman, P.P. Kooij, H.Y. Oei, et al.
Somatostatin receptor scintigraphy with [111In-DTPAD-Phe1]-and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1,000 patients.
Eur J Nucl Med., 20 (1993), pp. 716-731
[20.]
R. Arnold, B. Simon, M. Wied.
Treatment of neuroendocrine GEP tumours with somatostatin analogues: a review.
Digestion., 62 (2000), pp. 84-91
[21.]
J.O. Olsen, R.V. Pozderac, G. Hinkle, T. Hill, T.M. O’Dorisio, W.J. Schirmer, et al.
Somatostatin receptor imaging of neuroendocrine tumors with indium-111 pentetreotide (Octreoscan).
Semin Nucl Med., 25 (1995), pp. 251-261
[22.]
E.P. Krenning, D.J. Kwekkeboom, M. De Jong, T.J. Visser, J.C. Reubi, W.H. Bakker, et al.
Essentials of peptide receptor scintigraphy with emphasis on the somatostatin analog octreotide.
Semin Oncol., 21 (1994), pp. 6-14
[23.]
E.P. Krenning, D.J. Kwekkeboom, H.Y. Oei, R.J. De Jong, F.J. Dop, J.C. Reubi, et al.
Somatostatin-receptor scintigraphy in gastroenteropancreatic tumors. An overview of European results.
Ann N Y Acad Sci., 733 (1994), pp. 416-424
[24.]
E.P. Krenning, D.J. Kwekkeboom, Y. Oei, J.C. Reubi, S.W. Lamberts.
Octreotide agent shows peptide imaging potential.
Diagn Imaging (San Franc), 15 (1993), pp. 88-91
[25.]
E.P. Krenning, D.J. Kwekkeboom, J.C. Reubi, P.M. Van Hagen, C.H. Van Eijck, H.Y. Oei, et al.
111In-octreotide scintigraphy in oncology.
Digestion., 54 (1993), pp. 84-87
[26.]
A. Chiti, S. Fanti, G. Savelli, A. Romeo, B. Bellañova, M. Rodari, et al.
Comparison of somatostatin receptor imaging, computed tomography and ultrasound in the clinical management of neuroendocrine gastro-entero-pancreatic tumours.
Eur J Nucl Med., 25 (1998), pp. 1396-1403
[27.]
F. Gibril, J.C. Reynolds, J.L. Doppman, C.C. Chen, D.J. Venzon, B. Termanini, et al.
Somatostatin receptor scintigraphy: its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas. A prospective study.
Ann Intern Med., 125 (1996), pp. 26-34
[28.]
F. Gibril, J.C. Reynolds, C.C. Chen, F. Yu, S.U. Goebel, J. Serraño, et al.
Specificity of somatostatin receptor scintigraphy: a prospective study and effects of false-positive localizations on management in patients with gastrinomas.
J Nucl Med., 40 (1999), pp. 539-553
[29.]
C.A. Hoefnagel, J. Schornagel, R.A. Valdes Olmos.
[131I] metaiodobenzylguanidine therapy of malignant pheochromocytoma: interference of medication.
J Nucl Biol Med., 35 (1991), pp. 308-312
[30.]
G.A. Kaltsas, P. Putignaño, J.J. Mukherjee, M.A. Satta, D.G. Lowe, K.E. Britton, et al.
Carcinoid tumours presenting as breast cancer: the utility of radionuclide imaging with 123I-MIBG and 111In-DTPA pentetreotide.
Clin Endocrinol (Oxf)., 49 (1998), pp. 685-689
[31.]
G. Kaltsas, M. Korbonits, E. Heintz, J.J. Mukherjee, P.J. Jenkins, S.L. Chew, et al.
Comparison of somatostatin analog and meta-iodobenzylguanidi-ne radionuclides in the diagnosis and localization of advanced neuroendocrine tumors.
J Clin Endocrinol Metab., 86 (2001), pp. 895-902
[32.]
L.J. Hofland, S.W. Lamberts.
Somatostatin receptor subtype expression in human tumors.
Ann Oncol., 12 (2001), pp. S31-S36
[33.]
C.J. Anderson, F. Dehdashti, P.D. Cutler, S.W. Schwarz, R. Laforest, L.A. Bass, et al.
64Cu-TETA-octreotide as a PET imaging agent for patients with neuroendocrine tumors.
J Nucl Med., 42 (2001), pp. 213-221
[34.]
E. Bombardieri, M. Maccauro, M.R. Castellani, A. Chiti, G. Procopio, E. Bajetta, et al.
Radioisotopic imaging of neuroendocrine tumours. Which radiopharmaceutical and which diagnostic procedure?.
Minerva Endocrinol., 26 (2001), pp. 197-213
[35.]
M. De Jong, D. Kwekkeboom, R. Valkema, E.P. Krenning.
Radiolabelled peptides for tumour therapy: current status and future directions. Plenary lecture at the EANM 2002.
Eur J Nucl Med Mol Imaging, 30 (2003), pp. 463-469
[36.]
B. Eriksson, M. Bergstrom, A. Sundin, C. Juhlin, H. Orlefors, K. Oberg, et al.
The role of PET in localization of neuroendocrine and adrenocortical tumors.
Ann N Y Acad Sci., 970 (2002), pp. 159-169
[37.]
J.J. Erasmus, H.P. McAdams, E.F. Patz Jr., R.E. Coleman, V. Ahuja, P. Goodman.
Evaluation of primary pulmonary carcinoid tumors using FDG PET.
AJR Am J Roentgenol., 170 (1998), pp. 1369-1373
[38.]
S. Adams, R. Baum, T. Rink, P.M. Schumm-Drager, K.H. Usadel, G. Hor.
Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours.
Eur J Nucl Med., 25 (1998), pp. 79-83
[39.]
T. Zimmer, K. Ziegler, M. Baden, U. Fett, B. Hamm, E.O. Riecken, et al.
Localization of neuroendocrine tumors of the upper gastrointestinal tract.
Gut., 35 (1994), pp. 471
[40.]
C. Dromain, T. De Baere, J. Lumbroso, M. Caillet, A. Laplanche, V. Boige.
Detection of liver metastases from endocrine tumors: a prospective comparison of somatostatin receptor scintigraphy, computed tomography and magnetic resonance imaging.
J Clin Oncol., 23 (2005), pp. 70
[41.]
R.F. Thoeni, U.G. Mueller-Lisse, R. Chan, N.K. Do, P.B. Shyn.
Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity.
Radiology., 214 (2000), pp. 483-490
[42.]
J.F. London, T.H. Shawker, J.L. Doppman, H.H. Frucht, R. Vinayek, H.A. Stark, et al.
Zollinger-Ellison syndrome: prospective assessment of abdominal US in the localization of gastrinomas.
Radiology., 178 (1991), pp. 763-767
[43.]
C.M. King, R.H. Reznek, J.E. Dacie, J.A. Wass.
Imaging islet cell tumours.
Clin Radiol., 49 (1994), pp. 295-303
[44.]
R.T. Jensen.
Gastrointestinal endocrine tumours. Gastrinoma.
Baillieres Clin Gastroenterol., 10 (1996), pp. 603-643
[45.]
R. Arnold.
Medical treatment of metastasizing carcinoid tumors.
World J Surg., 20 (1996), pp. 203-207
[46.]
R. Arnold, M. Frank.
Gastrointestinal endocrine tumours: medical management.
Baillieres Clin Gastroenterol., 10 (1996), pp. 737-759
[47.]
P.N. Maton.
Use of octreotide acetate for control of symptoms in patients with islet cell tumors.
World J Surg., 17 (1993), pp. 504-510
[48.]
D.C. Metz, D.B. Strader, M. Orbuch, P.D. Koviack, K.M. Feigenbaum, RT. Jensen.
Use of omeprazole in Zollinger-Ellison syndrome: a prospective nine-year study of efficacy and safety.
Aliment Pharmacol Ther., 7 (1993), pp. 597-610
[49.]
Goldfinger SD. Management and prognosis of the Zollinger-Ellison syndrome (gastrinoma). Up To Date. 2006.
[50.]
P. Brazeau, W. Vale, R. Burgus, et al.
Hypothalamic peptide that inhibit the secretion of immunoreactive pituitary growth hormone.
Science., 179 (1973), pp. 77-79
[51.]
K. Öberg, M. Kvols, M. Caplin, G. Delle Fave, W. de Herder, G. Rindi, et al.
Consensus report on the use of somatostatin analogs for the manegement of neuroendocrine tumors of the gastroenteropancreatic system.
Ann Oncol., 15 (2004), pp. 996-1073
[52.]
L. Degen, C. The role of octreotide in the treatment of gastroenteropancreatic endocrine tumors Beglinger.
Digestion, 60 (1999), pp. 9-14
[53.]
B. Eriksson, K. Oberg.
Summing up 15 years of somatostatin analog therapy in neuroendocrine tumors: future outlook.
Ann Oncol., 10 (1999), pp. S31-S38
[54.]
M. Di Bartolomeo, E. Bajetta, R. Buzzoni, L. Mariani, C. Carnaghi, L. Somma, et al.
Clinical efficacy of octreotide in the treatment of metastatic neuroendocrine tumors. A study by the Italian Trials in Medical Oncology Group.
Cancer, 77 (1996), pp. 402-408
[55.]
M. Ducreux, P. Ruszniewski, J.A. Chayvialle, J. Blumberg, D. Cloarec, H. Michel, et al.
The antitumoral effect of the long-acting somatostatin analog lanreotide in neuroendocrine tumors.
Am J Gastroenterol., 95 (2000), pp. 3276-3281
[56.]
S. Ricci, A. Antonuzzo, L. Galli, M. Ferdeghini, L. Bodei, C. Orlandini, et al.
Octreotide acetate long-acting release in patients with metastatic neuroendocrine tumors pretreated with lanreotide.
Ann Oncol., 11 (2000), pp. 1127-1130
[57.]
L. Dogliotti, M. Tampellini, M. Stivanello, G. Gorzegno, L. Fabiani.
The clinical management of neuroendocrine tumors with long-acting repeatable (LAR) octreotide: comparison with standard subcutaneous octreotide therapy.
Ann Oncol., 12 (2001), pp. S105-S109
[58.]
S.W. Lamberts, A.J. Van der Lely, L.J. Hofland.
New somatostatin analogs: will they fulfil old promises?.
Eur J Endocrinol., 146 (2002), pp. 701-705
[59.]
C. Bruns, I. Lewis, U. Briner, G. Meno-Tetang, G. Weckbecker.
SOM230: a novel somatostatin peptidomimetic with broad somatotropin release inhibiting factor (SRIF) receptor binding and a unique antisecretory profile.
Eur J Endocrinol., 146 (2002), pp. 707-716
[60.]
K. Oberg, B. Eriksson, E.T. Janson.
The clinical use of interferons in the management of neuroendocrine gastroenteropancreatic tumors.
Ann N Y Acad Sci., 733 (1994), pp. 471-478
[61.]
K. Oberg.
Neuroendocrine gastrointestinal tumors-a condensed overview of diagnosis and treatment.
Ann Oncol., 10 (1999), pp. S3-S8
[62.]
K. Oberg.
Interferon in the management of neuroendocrine GEP-tumors: a review.
Digestion., 62 (2000), pp. 92-97
[63.]
D. Grander, O. Sangfelt, S. Erickson.
How does interferon exert its cell growth inhibitory effect?.
Eur J Haematol., 59 (1997), pp. 129-135
[64.]
B. Eriksson, K. Oberg.
An update of the medical treatment of malignant endocrine pancreatic tumors.
Acta Oncol., 32 (1993), pp. 203-208
[65.]
M. Frank, K.J. Klose, M. Wied, N. Ishaque, C. Schade-Brittinger, R. Arnold.
Combination therapy with octreotide and a-interferon: effect on tumor growth in metastatic endocrine gastroenteropancreatic tumors.
Am J Gastroenterol., 94 (1999), pp. 1381-1387
[66.]
S. Faiss, U.F. Pape, M. Bohmig, Y. Dorffel, U. Mansmann, W. Golder, et al.
Prospective, randomized, multicenter trial on the antiproliferative effect of lanreotide, interferon a, and their combination for therapy of metastatic neuroendocrine gastroenteropancreatic tumors-the International Lanreotide and Interferon Alfa Study Group.
J Clin Oncol., 21 (2003), pp. 2689-2696
[67.]
K. Öberg.
Chemotherapy and biotherapy in the treatment of neuroendocrine tumours.
Ann Oncol., 12 (2001), pp. S111-S114
[68.]
K. Öberg.
Advances in chemotherapy and biotherapy of endocrine tumors.
Curr Opin Oncol., 10 (1998), pp. 58-65
[69.]
G. Kaltsas, J.J. Mukherjee, P.N. Plowman, A.B. Grossman.
The role of the chemotherapy in the nonsurgical management of malignant neuroendocrine tumours.
Clin Endocrinol (Oxf), 55 (2001), pp. 575-587
[70.]
K. Öberg.
State of the art and future prospects in the management of neuroendocrine tumors.
Q J Nucl Med., 44 (2002), pp. 3-12
[71.]
P. Rougier, E. Mitry.
Chemotherapy in the treatment of neuroendocrine malignant tumors.
Digestion., 62 (2000), pp. 73-78
[72.]
C.G. Moertel.
Karnofsky memorial lecture. An odyssey in the land of small tumors.
J Clin Oncol., 5 (1987), pp. 1502-1522
[73.]
B. Eriksson, B. Skogseid, G. Lundqvist, L. Wide, E. Wilander, K. Oberg.
Medical treatment and long-term survival in a prospective study of 84 patients with endocrine pancreatic tumors.
Cancer, 65 (1990), pp. 1883-1890
[75.]
K. Oberg.
The use of chemotherapy in the management of neuroendocrine tumors.
Endocrinol Metab Clin North Am., 22 (1993), pp. 941-952
[76.]
C.G. Moertel, M. Lefkopoulo, S. Lipsitz, R.G. Hahn, D. Klaassen.
Streptozocin-doxorubicin, streptozocin-fluorouracil or chlorozotocin in the treatment of advanced islet-cell carcinoma.
N Engl J Med., 326 (1992), pp. 519-523
[77.]
P.F. Engstrom, P.T. Lavin, C.G. Moertel, E. Folsch, H.O. Douglass Jr..
Streptozocin plus fluorouracil versus doxorubicin therapy for metastatic carcinoid tumor.
J Clin Oncol., 2 (1984), pp. 1255-1259
[78.]
C.G. Moertel, J.A. Hanley, L.A. Johnson.
Streptozocin alone compared with streptozocin plus fluorouracil in the treatment of advanced isletcell carcinoma.
N Engl J Med., 303 (1980), pp. 1189-1194
[79.]
L.E. Broder, S.K. Carter.
Pancreatic islet cell carcinoma. II. Results of therapy with streptozotocin in 52 patients.
Ann Intern Med., 79 (1973), pp. 108-118
[80.]
R.M. Bukowski, C. Tangen, R. Lee, J.S. Macdonald, A.B. Einstein Jr., R. Peterson, et al.
Phase II trial of chlorozotocin and fluorouracil in islet cell carcinoma: a Southwest Oncology Group study.
J Clin Oncol., 10 (1992), pp. 1914-1918
[81.]
E. Bajetta, L. Rimassa, C. Carnaghi, E. Seregni, L. Ferrari, M. Di Bartolomeo, et al.
5-Fluorouracil, dacarbazine, and epirubicin in the treatment of patients with neuroendocrine tumors.
Cancer, 83 (1998), pp. 372-378
[82.]
E. Rivera, J.A. Ajani.
Doxorubicin, streptozocin, and 5-fluorouracil chemotherapy for patients with metastatic islet-cell carcinoma.
Am J Clin Oncol., 21 (1998), pp. 36-38
[83.]
G.A. Kaltsas, J.J. Mukherjee, A. Isidori, B. Kola, P.N. Plowman, J.P. Monson, et al.
Treatment of advanced neuroendocrine tumours using combination chemotherapy with lomustine and 5-fluorouracil.
Clin Endocrinol (Oxf), 57 (2002), pp. 169-183
[84.]
H. Ahlman, B. Wangberg, S. Jansson, S. Friman, M. Olausson, U. Tylen, et al.
Interventional treatment of gastrointestinal neuroendocrine tumours.
Digestion., 62 (2000), pp. 59-68
[85.]
H. Chen, J.M. Hardacre, A. Uzar, J.L. Cameron, M.A. Choti.
Isolated liver metastases from neuroendocrine tumors: does resection prolong survival?.
J Am Coll Surg., 187 (1998), pp. 88-92
[86.]
R.S. Chamberlain, D. Canes, K.T. Brown, L. Saltz, W. Jarnagin, Y. Fong, et al.
Hepatic neuroendocrine metastases: does intervention alter outcomes?.
J Am Coll Surg., 190 (2000), pp. 432-445
[87.]
P. Ruszniewski, D. Malka.
Hepatic arterial chemoembolization in the management of advanced digestive endocrine tumors.
Digestion, 62 (2000), pp. 79-83
[88.]
G.A. Wiseman, L.K. Kvols.
Therapy of neuroendocrine tumours with radiolabeled MIBG and somatostatin analogues.
Semin Nucl Med., 25 (1995), pp. 272-278
[89.]
E.P. Krening, M. De Jong, P.P. Kooij, W.A. Breeman, W.H. Baker, W.W. De Herder, et al.
Radiolabelled somatostatin analogues for peptide receptor scintigraphy and radionuclide therapy.
Ann Oncol., 10 (1999), pp. S23-S29
[90.]
D. Kwekkeboom, E.P. Krenning, M. De Jong.
Peptide receptor imaging and therapy.
J Nucl Med., 41 (2000), pp. 1704-1731
[91.]
M. Fjalling, P. Andersson, E. Forssell-Aronsson, J. Gretarsdottir, V. Johansson, L.E. Tisell, et al.
Systemic radionuclide therapy using indium-111-DTPA-D-Phe1-octreotide in midgut carcinoid syndrome.
J Nucl Med., 37 (1996), pp. 1519-1521
[92.]
J.R. Buscombe, M.E. Caplin, A.J. Hilson.
Long-term efficacy of high-activity 111in-pentetreotide therapy in patients with disseminated neuroendocrine tumors.
J Nucl Med., 44 (2003), pp. 1-6
[93.]
M. De Jong, R. Valkema, F. Jamar, L.K. Kvols, D.J. Kwekkeboom, W.A. Breeman, et al.
Somatostatin receptor-targeted radionuclide therapy of tumors: preclinical and clinical findings.
Semin Nucl Med., 32 (2002), pp. 133-140
[94.]
M.L. Brandi, R.F. Gagel, A. Angeli, P. Beck-Pecoz, C. Bordi, B. Conte-Dekvix, et al.
CONSENSUS: guidelines for diagnosis and therapy of MEN type 1 and Type 2.
J Clin Endocrinol Metabol., 12 (2001), pp. 5658-5671
[95.]
U. Plöckinger, G. Rindi, R. Arnold, B. Eriksson, E.P. Krenning, A. Goede, et al.
Guidelines for the diagnosis and treatment of neuroendocrine gastrointestinal tumours.
Neuroendocrinology, 80 (2004), pp. 394-424
[96.]
H. Shomanesh, F. Gribil, A. Louie, J.V. Ojeaburu, S. Bashir, A. Abou-Saif, et al.
Prospective study of the antitumor efficacy of long-term octreotide treatment in patients with progressive metastatic gastrinoma.
Cancer, 94 (2002), pp. 331-343
[97.]
F. Saijo, H. Naito, Y. Funayama, K. Fukushima, C. Shibata, A. Hashimoto, et al.
Octreotide in control of multiple liver metastases from gastrinoma.
J Gastroenterol, 38 (2003), pp. 905-908
Copyright © 2007. Sociedad Española de Endocrinología y Nutrición