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Consensus on the clinical diagnosis and treatment of grade 3 pancreatic neuroendocrine tumors

Journal of Pancreatology 2024年第2期7卷 97-105页

作者： Jie Chen Wenming Wu Chunmei Bai Yihebali Chi Li Huo Liming Jiang Yuan Ji Jie Luo Jie Li Jingnan Li Wenhui Lou Chenghao Shao Lin Shen Feng Wang Yu Wang Ling Xue Jin Xu Chunhui Yuan Xianjun Yu Xiaoyu Yin Hong Zhao Xiongzeng Zhu Yupei Zhao Centre for Neuroendocrine Tumors Fudan University Shanghai Cancer CenterShanghai 200032China Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Medical Oncology Peking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing 100730China Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Nuclear Medicine State Key Laboratory of Complex Severe and Rare DiseasesBeijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear MedicinePeking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Department of Diagnostic Radiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Pathology Zhongshan HospitalFudan UniversityShanghai 200032China Department of Pathology China-Japan Friendship HospitalBeijing 100029China Department of Gastroenterological Oncology Beijing Cancer HospitalPeking University Cancer Hospital&InstituteBeijing 100142China Department of Gastroenterology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Department of Pancreatic Surgery Zhongshan HospitalFudan UniversityShanghai 200032China Department of Pancreatic-Biliary Surgery Second Affiliated Hospital of Naval Medical UniversityShanghai 200003China Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer Hospital&InstituteBeijing 100142China Department of Nuclear Medicine Nanjing First HospitalNanj

The World Health Organization(WHO)2017 classifications for neuroendocrine neoplasms(NENs)subdivided grade 3 pancreatic neuroendocrine neoplasms(pNENs)into G3 well-differentiated pancreatic neuroendocrine tumors(G3 pNETs)and poorly differentiated pancreatic neuroendocrine carcinomas(pNECs),according to the mitotic count,Ki-67 index,and cell *** a new category,G3 pNETs remain a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical ***,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.

关键词： Clinical diagnosis grade 3 Pancreatic neuroendocrine tumors Treatment

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Combined effects of MPA and EBRT in stage Ic endometrial cancer patients

引用

The Chinese-German Journal of Clinical Oncology 2008年第11期7卷 650-657页

作者： Rumana Jafarey Wei Zhang Sun Jing Department of Gynecology and Obstetrics Renmin Hospital of Wuhan University Wuhan 430060 China Department of Health Statistics School of Public Health Wuhan University Wuhan 430072 China

Objective： To report the comparative effect of combined medroxyprogesterone acetate （MPA） and external beam pelvic radiotherapy （EBRT） with EBRT alone on local or distant recurrences, overall survival and treatment related toxicities in patients with stage Ic grade 3 endometrial cancer. Methods： A retrospective review of 80 International Federation of Gyne- cology and Obstetrics （FIGO） stage Ic grade 3 endometrial carcinoma patients treated between October 1994 and October 2004 at Renmin Hospital, Wuhan University, China was performed. All patients underwent surgery, of which 40 patients in arm I received combined MPA and EBRT while in arm II 40 patients received only adjuvant EBRT after surgery. The median dose of EBRT in arm I was 50 Gy （range 36-54 Gy） and in arm Ⅱ was 45.2 Gy （range 43.2-50.4 Gy）. Multivariate analysis was performed for the prognostic factors and Kaplan-Meier method was used for overall survival. Results： Of the 80 eligible patients, 40 in each group could be evaluated. The follow-up times ranged from 4-98 months with a median of 45 months. The overall survival rates at five years were 73% among patients treated with combined MPA and EBRT and 28.2% among patients treated with EBRT alone （P 〈 0.001）. The rate of distant metastasis was significantly higher among patients treated with EBRT alone group than combined MPA and EBRT （55% vs 25%, P = 0.006） while no difference in Ioco regional recurrence rates was observed in both treatment groups. Most of the side effects observed in the combined MPA and EBRT group. Age （P 〈 0.001） and the presence of progesterone receptors （P = 0.003） were independent significant prognostic factors for overall surviva} in multiple regression analysis. Conclusion： We has been concluded that the addition of progestagen to external beam pelvic radiotherapy significantly improved survival and reduced distant metastasis among women with stage Ic grade 3 endometrial cancer.

关键词： endometrial carcinoma FIGO stage Ic grade 3 medroxyprogesterone acetate (MPA) external beam pelvicradiotherapy (EBRT)

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