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Радионуклидная визуализация и терапия у пациентов с нейроэндокринными опухолями

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Нейроэндокринные опухоли представляют собой гетерогенную группу опухолей, возникающих из энтерохромаффинных клеток диффузной нейроэндокринной системы и встречающихся в 0,5% случаев всех новообразований. За последние годы отмечается значительный рост заболеваемости нейроэндокринными опухолями, что безусловно связано с усовершенствованием методов их диагностики. Однако, несмотря на значительные успехи в изучении биологических и молекулярных механизмов поведения данной группы заболеваний, формирование единого алгоритма диагностики и лечения нейроэндокринных опухолей остается затруднительным и по сей день. Лечение нейроэндокринных опухолей во многом зависит от их функционального статуса и стадии заболевания. Наиболее предпочтительным подходом в лечении локализованных форм нейроэндокринных опухолей остается хирургический. В то же время для больных с распространенными процессами, характеризующимися наличием отдаленных метастазов, на сегодняшний день доступен широкий спектр терапевтических стратегий. Среди них можно выделить контроль над синдромами, ассоциированными с гиперсекрецией тех или иных гормонов, выполнение циторедуктивных вмешательств, системную химиотерапию, применение аналогов соматостатина, а также радиотаргетную терапию. Однако алгоритм выбора того или иного терапевтического подхода в современной клинической практике у разнородной группы больных с нейроэндокринными опухолями требует дальнейшего обсуждения.

Ключевые слова:
нейроэндокринные опухоли, радионуклидная диагностика, радиотаргетная терапия, аналоги соматостатина, октреотид, онкология, радиология, neuroendocrine tumors, radionuclide imaging, radiolabeled therapy, somatostatin analogues, octreotide, oncology, radiology

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Radionuclide imaging and therapy in patients with neuroendocrine tumors

Neuroendocrine tumors (NETs) are heterogeneous group of the tumors that arise from the enterochromaffin cells of the diffuse neuroendocrine system and occurr in 0.5% of all neoplasms. Recently there has been a significant increase in the incidence of neuroendocrine tumors, which is undoubtedly associated with the improvement of diagnostic methods. However, despite significant success in studying the biological and molecular mechanisms of its behavior, a single algorithm for the diagnosis and treatment of neuroendocrine tumors remains unclear today. Treatment of neuroendocrine tumors largely depends on their functional status and the stage of the disease. While the treatment of localized NETs is surgical resection, varieties of therapeutic options are available for patients with advanced NETs. These include medical control of excess hormone levels and associated symptoms, cytoreductive surgery for patients with advanced disease, systemic chemotherapy, somatostatin analogues, and peptide receptor-targeted radionuclide therapy. However, the right choice of the therapeutic approach in current clinical practice in heterogeneous group of patients with neuroendocrine tumors requires further discussion.

Keywords:
нейроэндокринные опухоли, радионуклидная диагностика, радиотаргетная терапия, аналоги соматостатина, октреотид, онкология, радиология, neuroendocrine tumors, radionuclide imaging, radiolabeled therapy, somatostatin analogues, octreotide, oncology, radiology