| Popis: |
Introduction To evaluate the effectiveness of XELOX in patients with disseminated neuroendocrine tumors (NET) of gastrointestinal tract. Methods 50 patients with morphologically verified NET of gastrointestinal tract,17 (34%) men and 33 (66%) women aged 19-75, mean age 55.5±11.8 years. Among them 2 patients (4%) had gastric NET, 18 (36%) - pancreatic NET, 18 (36%) - intestinal NET, in 12 patients (24%) the primary tumor was not identified. G1 tumor was verified in one case (8%), G2 – in 31 patients (62%), G3 – in 10 patients (20%), in 5 patients (10%) the tumor was only verified by cytological study. Thirty-three patients (66%) had liver metastatic disease. Clinical manifestations of carcinoid syndrome with elevation of serum chromogranin A and serotonin and urinary 5-HIAA levels were seen in 31 (62%) patients with well-differentiated tumors. Additional therapy by somatostatin analogs received 30 patients (60%). Chemotherapy regimen: oxaliplatin 120 mg/m2 day 1, capecitabine 2000 mg/m2 days 1-14. Mean follow-up time was 28 months. Results The overall number of chemotherapy courses was 242. Stabilization was seen in 44 patients (88%), progression - in 6 patients (12%). Biochemical effect confirmed by decrease in chromogranin and/or serotonin serum level was observed in 28 patients (44%). Median progression-free survival time was 14 months, 60% of patients showed no signs of progression for one year. Patients with clinical and biochemical manifestations of carcinoid syndrome receive additional treatment with somatostatin analogs or interferons. Median survival is not reached. Conclusion ХELOХ regimen may be used for disease control in patients with disseminated well- and poorly differentiated NET of gastrointestinal tract in first and following treatment lines. |
