USE OF OCTREOTIDE ACETATE FOR CONTROL OF SYMPTOMS IN PATIENTS WITH ISLET-CELL TUMORS

Gut tumor syndromes are rare, occurring in less than two cases per mil lion population per year: Insulinomas are most common and gastrinomas are less common; all the others are extremely rare. Conventional treat ment of the symptoms caused hy these tumors has included surgery, hepa tic arterial embolization, and chemotherapy; some patients with Zollin ger-Ellison syndrome (ZES) have been treated with specific agents such as gastric antisecretory drugs. The development of octreotide, a synt hetic, long-acting analogue of the natural peptide somatostatin, has o ffered an alternative to such therapies. Octreotide has a half life of > 100 minutes and inhibits both physiological- and tumor release of m any peptides. It also has direct effects on the gut that modify secret ion and motility. Octreotide has been shown to be particularly useful for the symptoms of tumors producing vasoactive intestinal peptide (VI P), and of the carcinoid syndrome. It is also useful in patients with glucagonomas, with growth hormone-releasing hormone producing tumors, and in some patients with Cushing's syndrome and unresectable insulino mas. Octreotide is effective in patients with ZES, but alternative the rapies such as omeprazole are more effective, safer, and more convenie nt for those patients. Side effects of octreotide have not been troubl esome in these patients, but the incidence of long term effects is sti ll not entirely clear. Octreotide has proved to be a significant advan ce in the treatment of patients with islet cell tumors.