NCCN临床实践指南_神经内分泌肿瘤和肾上腺瘤(2018.V4)英文版
139页1、Neuroendocrine and Adrenal Tumors Version 4 2018 January 07 2019 NCCN org NCCN Guidelines for Patients available at www nccn org patients NCCN Clinical Practice Guidelines in Oncology NCCN Guidelines Continue Version 4 2018 01 07 19 National Comprehensive Cancer Network Inc 2019 All rights reserved The NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN Manisha H Shah MD Chair The Ohio State University Comprehensive Cancer Center
2、 James Cancer Hospital and Solove Research Institute Matthew H Kulke MD Chair Dana Farber Brigham and Women s Cancer Center Whitney S Goldner MD Vice Chair Fred CT with IV contrast when possible Footnote revised If disease progression treatment with octreotide or lanreotide should be continued in patients with functional tumors and may be used in combination with any of the subsequent options For details on the administration of octreotide or lanreotide with 177Lu dotatate see NE E Footnote adde
3、d where 177Lu dotatate is recommended See Principles of Peptide Receptor Radionuclide Therapy PRRT with lutetium 177 Lu dotatate 177Lu Dotatate NE E NET 8 Added to primary therapy with octreotide or lanreotide if somatostatin receptor positive and or hormonal symptoms Also on NET 9 Added the following option for patients with clinically significant tumor burden and low grade typical bronchopulmonary thymus tumors or those with evidence of progression Consider PRRT with 177Lu dotatate if somatost
4、atin receptor positive and progression on octreotide lanreotide Also on NET 9 for intermediate grade atypical bronchopulmonary thymus tumors Moved treatment recommendations for those with intermediate grade atypical disease and those with multiple lung nodules or tumorletes and evidence of DIPNECH to NET 9 NET 10 Added the following option for patients with unresectable locoregional advanced disease of the GI tract and or distant metastases if disease progression following therapy with octreotid
5、e or lanreotide PRRT with 177Lu dotatate if somatostatin receptor positive category 1 for mid gut tumors Removed consider from the following options for those with disease progression following therapy with octreotide or lanreotide Hepatic directed therapy for hepatic predominant disease Interferon alfa 2b category 3 Cytotoxic chemotherapy category 3 if no other options feasible Added footnote hh Treatment with octreotide or lanreotide will likely only benefit those patients who are somatostatin
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