Peritoneal metastasis in gastroenteropancreatic neuroendocrine tumors poses a significant clinical challenge, with limited data guiding management strategies. We review the existing literature on surgical and systemic treatment modalities for peritoneal metastasis from gastroenteropancreatic neuroendocrine tumors. Surgical interventions, including cytoreductive surgery, have shown promise in improving symptom control and overall survival—particularly in cases in which 70% cytoreduction can be achieved. Hyperthermic intraperitoneal chemotherapy remains controversial due to a paucity of high-level evidence and a lack of consensus for routine use. The use of systemic therapy in the setting of peritoneal metastasis from gastroenteropancreatic neuroendocrine tumors is extrapolated from high-quality evidence for its use in the setting of the solid organ metastasis of this disease. The use of somatostatin analogs for symptom control and some antiproliferative effects is supported by large clinical trials. Additional strong evidence exists for the use of interferon-alpha, everolimus, and sunitinib, particularly in pancreatic neuroendocrine tumors. Cytotoxic chemotherapy and peptide receptor radionuclide therapy may be used in select cases, though as an emerging treatment modality, the optimal sequence of peptide receptor radionuclide therapy within the existing algorithms is unknown. Significant gaps in understanding and standardized management exist, particularly for those patients presenting with peritoneal metastasis, and targeted research to optimize outcomes in this population is needed.
胃肠胰神经内分泌肿瘤的腹膜转移构成了显著的临床挑战，目前指导治疗策略的数据有限。本文综述了胃肠胰神经内分泌肿瘤腹膜转移的外科及全身治疗方式的现有文献。外科干预（包括肿瘤细胞减灭术）在改善症状控制和总体生存方面显示出潜力——特别是在能达到70%肿瘤减灭的病例中。腹腔热灌注化疗由于缺乏高质量证据且未形成常规应用共识，其疗效仍存争议。针对胃肠胰神经内分泌肿瘤腹膜转移的全身治疗应用，是基于该疾病实体器官转移的高质量证据推导而来。大型临床试验支持使用生长抑素类似物进行症状控制并发挥一定抗增殖作用。另有充分证据支持使用α-干扰素、依维莫司和舒尼替尼，尤其在胰腺神经内分泌肿瘤中。细胞毒性化疗和肽受体放射性核素治疗可在特定病例中使用，但作为一种新兴治疗方式，肽受体放射性核素治疗在现有治疗体系中的最佳序贯方案尚未明确。当前对腹膜转移患者的认知和标准化管理存在显著空白，亟需开展针对性研究以优化该人群的治疗结局。
肿瘤(癌症)患者之家