Treatment of Neuroendocrine Tumors with Selective Internal Radiation Therapy
The pathophysiology of neuroendocrine tumors (NET) is discussed and the differences in types of tumors within this broad category are highlighted. While carcinoid is the most common of the NETs, the general principles of treatment can be extrapolated to the NETs in general. The chemotherapy treatments have not been historically very effective and the major treatment is surgery with removal of the primary as well as debulking metastases. This regimen only occurs in a small minority of patients since the disease has metastasized to the liver in 90 % of cases. Unresectable disease can be treated with modern chemotherapy for small cell cancer with reasonable results but loco-regional treatment of the liver disease is the primary treatment utilized. While ablative therapies can treat one lesion at a time, most patients benefit from having a regional approach to their treatment. Use of 90Yttrium beads has been demonstrated to not only be safe and effective but also to permit significant quality of life since the treatments are performed on an outpatient basis.
KeywordsNeuroendocrine Tumor Carcinoid Tumor Carcinoid Syndrome Selective Internal Radiation Therapy Midgut Carcinoid
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