Clinical Study Of Traditional Chinese Medicine Combined With Somatostatin Analogue In The Treatment Of Advanced Gastric Neoplasms With Rumen And Intestine

BACKGROUND:Somatostatin analogues (SSA) are recommended as a first-line treatment of patients with gastroenteropancreatic neuroendocrine tumours (GEP-NET);however,there is no report about the treatment of GEP-NET with Traditional Chinese Medicine(TCM) now. The aim of our study was to evaluate the efficacy and safety of TCM combined with SSA treatment for advanced GEP-NET, and to explore the significance of serum CgA in monitoring the condition of GEP-NET patients.METHODS:To include the patients with advanced gastroenteropancreatic neuroendocrine tumors who were treated in Oncology department of China-Japan Friendship Hospital from September 2011 to February 2016.Patients were treated with TCM combined with SSA,the treating method was to give Octreotide (20mg, intramuscular injection,3-4weeks intervals) or Lanreotide(40mg,intramuscular injection,10-14 days intervals).At the same time according to the conditions of patients, treated by TCM dialectical therapy(a dose of daily,twice daily). Evaluating efficacy according to the RECIST version 1.1 criteria, and detecting serum CgA by radioimmunoassay (IRMA).The primary end point was time to tumour progression(TTP). Compare data with reported literature.RESULTS:The study included 39 standard-compliant patients,among whom 16 are famale,23 are male,their median age was 51(25-79).Primary site:19 cases of pancreas,8 cases of rectum,8 cases of small intestine,1 cases of stomach,3 cases of primary lesions were unknown.33 cases were nonfunctional tumors,6 cases were functional tumors. According to the 2010WHO version of GEP-NET pathological grading,10 cases were G1,29 cases were G2.Somatostatin receptor scintigraphy(SRS) was positive in 27 cases,2 cases were negative and 10 cases were unknown. TCM combined with SSA (28 cases with octreotide,11 cases with lanreotide)treatment, median time to tumor progression was 22.9months.In 13 cases with progressive disease,the serum CgA leval of 9 cases were higher and 4 cases were lower than baseline (2 cases had reduced in the normal range). In 13 patients with stable disease, the serum CgA leval of 8 cases were lower than baseline,and 5 cases rised in the range of normal values.CONCLUSIONS:TCM combined with SSA treatment compared with the SSA alone can significantly prolonged the TTP of patients with advanced GEP-NET (22.9m vs 14.3m). Serum CgA can be used to monitor the condition of patients with GEP-NET.