Recurrent Islet Cell Carcinoma
Deciding on further treatment depends on many factors, including the specific
cancer, prior treatment, and site of recurrence, as well as individual patient
considerations. Clinical trials are appropriate and should be considered when
possible. Information about ongoing clinical
trials is available at the NCI Cancer.gov Web site. Attempts at
re-resection are worthwhile for patients with gastrinomas, insulinomas, and
glucagonomas. Somatostatin analogues will aid in control of syndromes of some
of these tumors. Intra-arterial chemotherapy has been useful for a number of
patients with liver metastases. Patients with hepatic-dominant disease and
substantial symptoms caused by tumor bulk or hormone-release syndromes may
benefit from continuous-infusion intra-arterial chemotherapy or procedures that
reduce hepatic arterial blood flow to metastases (hepatic arterial occlusion
with embolization or with chemoembolization). Such treatment may also be
combined with systemic chemotherapy in selected patients.
Moertel CG, Johnson CM, McKusick MA, et al.: The management of patients with advanced carcinoid tumors and islet cell carcinomas. Ann Intern Med 120 (4): 302-9, 1994.