Streptozotocin Therapy Research Articles

417 Role of Preoperative 5-Fluorouracil, Doxorubicin and Streptozotocin Therapy in the Treatment of Localized Pancreatic Neuroendocrine Tumors

417 Role of Preoperative 5-Fluorouracil, Doxorubicin and Streptozotocin Therapy in the Treatment of Localized Pancreatic Neuroendocrine Tumors

ストレプトゾトシンにより治療したインスリノーマの犬の1例

dog diagnosed as insulinoma with concurrent peripheral polyneuropathy was treated with surgical resection and postoperative streptozotocin (STZ) therapy. Beginning on the 62nd postoperative day, intravenous administration of STZ (500mg/m2) was performed every three weeks. The dog's blood glucose level returned to the normal range and neurological signs improved after the administration of two doses of STZ. At the third administration of STZ, recurrent hypoglycemia was identified. The dog's condition did not improve and a seizure followed. The dog was euthanatized due to the development of the hypoglycemic seizure on the 127th postoperative day. Normoglycemia had been maintained without severe side effects, such as renal dysfunction, f or two months after the operation. We therefore suggest that STZ therapy is useful in the medical management of canine insulinoma.

Insulinoma After Streptozotocin Therapy for Metastatic Gastrinoma

Islet cell carcinoma frequently produces more than one chemical product, although its clinical expression is usually restricted to a single hormone. We describe an unusual patient who presented with full-blown metastasizing gastrinoma. He was treated with cimetidine for five years and then streptozotocin therapy, which resulted in a regression in hepatomegaly and a fall in serum gastrin levels. Following one year's therapy with streptozotocin, he was admitted in hyperinsulinemic hypoglycemic stupor. This appears to be the first reported case of a "shift" from clinical gastrinoma to insulinoma possibly related to prolonged streptozotocin therapy.

A Three Year Follow-Up Study of a Patient With a Malignant Islet Cell Tumour Treated With Streptozotocin

SummaryA 62 year old man with hepatic metastases from an insulin-producing islet cell tumour has successfully been treated with Streptozotocin. A selective celiac arteriography, performed after ten months, demonstrated complete disappearance of hepatic metastases. The patient remained well for three years without clinical or biological symptoms of recurrent disease; after this time however symptoms reappeared. A liver biopsy revealed metastases of a poorly differentiated adenocarcinoma. The patient died shortly afterwards due to generalized disease. The authors conclude that Streptozotocin therapy is the preferred treatment of metastatic insulinoma, and that even in cases of extensive metastatic involvement, long time survival is possible.

Treatment of Malignant Metastatic Pancreatic Insulinoma with Streptozotocin

The possibilities of treating different types of pancreatic islet cell cancer with the active drug streptozotocin have been studied in reports of 21 patients published during the last 8 years. The unusual features of the symptomatology, dosage and injection methods, side-effects after different infusion schedules and complications of streptozotocin therapy, are compared. A new case with pancreatic carcinoma and liver metastases was treated with a total dose of 14 g streptozotocin, divided into 7 injections with an increasing interval between them. This patient underwent a marked amelioration of the disease, without serious side-effects of the streptozotocin treatment. She has been apparently well for the 22 months which have now elapsed since the beginning of treatment. This seems to be one of the longest remission periods yet published in the insulinoma literature.

Proceedings: Malignant gastrinoma following total gastrectomy.

Half of all patients with the Zollinger-Ellison syndrome treated by total gastrectomy will eventually die from their tumor. The clinical course of four patients observed for at least four years is discussed. Three patients had liver metastases, responsible for the death of two and seriously affecting the third. The fourth had extensive tumor around the pancreas plus mesenteric metastases that were removed. The patient is doing well. Hepatic artery ligation, streptozotocin therapy, and internal radiation of the tumor were tried in an attempt to control the hepatic metastases. Hepatic scans, the serum gastrin response to calcium infusion, and hepatic angiography are useful techniques to assess continued tumor growth following total gastrectomy.

Treatment of malignant insulinoma with Streptozotocin.

Two patients with malignant insulinoma and hepatic metastases were treated with streptozotocin, administered directly into the celiac artery. Decreases in tumor size were documented radiographically. One patient was in a terminal state when first treated, but the other patient was in moderately good general health and responded well. Some side-effects, including renal tubular damage, were observed but were relatively minor. Streptozotocin therapy offers some benefit in patients with malignant insulinoma.