CLINICAL USE OF SOMATOSTATIN ANALOGS IN PEDIATRIC ONCOLOGY

Paediatric oncology continues to search for improved methods for the e arly detection and effective treatment of solid tumours, especially th ose of the nervous system, which constitute 50% of all solid tumours i n children and adolescents. These tumours, including neuroblastoma, me ningioma, low-grade astrocytoma and medulloblastoma-express somatostat in receptors and can be imaged effectively using In-111-octreotide. In addition to improved imaging techniques, somatostatin analogues are b eing developed for use in radioreceptor-guided surgery, asa component of adjuvant chemotherapy and for supportive treatment. Radioreceptor-g uided surgery utilises I-125-Tyr(3)-octreotide or I-125-lanreotide to detect tumour foci within minutes of injection. It allows the detectio n of 0.1-1.0 mg tumour (1 x 10(5) to 1 x 10(6) tumour cells). This tec hnique has successfully located foci of occult tumour in children with neuroblastoma. Somatostatin analogues are also currently being studie d as tumour growth inhibitors between regular chemotherapy cycles and for the treatment of chemotherapy-induced pancreatitis in children wit h leukaemia. Research on somatostatin receptor subtype expression in p aediatric tumours suggests that further investigation of analogue effe cts on growth inhibition and induction of differentiation will contrib ute to improved therapy for children with solid tumours.