Medical therapy of endocrine carcinomas. Part II: Malignant gastrinomas, insulinomas, glucagonomas, carcinoids und other carcinomas

Background: The thyroid gland and the adrenal glands are the most common si tes of endocrine carcinomas (see Part I of this review, Med Klin 2000;95:20 -5, Nr. 1). Less frequent are endocrine malignancies of the gastrointestina l (gastrinomas, insulinomas, glucagonomas, carcinoids and others). Treatment: Because of the rarity and missing prospective studies as well as radiotherapy and chemotherapy resistance of these tumors, generally accept ed conventional therapy guidelines ibr these endocrine carcinomas do not ex ist. surgery and radionucleotide treatment should be considered as first li ne therapy. Somatostatin analoga (octreotide) are Frequently used as well. Chemotherapy is usually not effective. Common substances are streptozotocin , 5-fluorouracil, doxorubicine, dacarbazine and cyclophosphamide.