Experience in treatment of metastatic pulmonary carcinoid tumors

Background: The only cure for patients with pulmonary carcinoids is surgery . In the present paper, we report the results of medical treatment of patie nts with metastatic tumors, their circulating hormone markers, and immunohi stochemical profile of the tumors. Patients and methods/Results: The response to systemic antitumoral treatmen t was studied in 31 patients with metastatic pulmonary carcinoids. Median s urvival from treatment start was 25 months. Alpha-interferon treatment has resulted in stable disease in 4 of 27 patients (median duration 15 months), while 23 patients showed progressive disease. Somatostatin analogues given as single drug treatment resulted in progressive disease. Streptozotocin a nd 5-fluorouracil resulted in progressive disease in seven of seven patient s. Stable disease was obtained for 8 and 10 months respectively in two of t wo patients treated with streptozotocin + doxorubicin. Two of eight patient s treated with cisplatinum + etoposide showed a significant decrease in tum or size lasting six and eight months respectively, and one displayed stable disease for seven months. Elevation of plasma chromogranin A was seen in 9 3%. Conclusions: The results of systemic antitumoral treatment of pulmonary car cinoids with distant metastases are generally discouraging. Chemotherapy wi th cisplatinum + etoposide, or doxorubicin combined with streptozotocin or paclitaxel may be of value. Alpha-interferon and octreotide offer efficient symptomatic relief, but stabilizes tumor growth in merely 15% of the cases . Plasma chromogranin A is the most frequently elevated tumor marker.