Abstract
The definitive treatment of a pancreatic tumour secreting vasoactive intestinal polypeptide is surgical removal of the tumour, but when curative resection is not possible symptomatic treatment of the endocrine hyperfunction is important. Streptozotocin, although effective for palliation, can involve unpleasant side effects. We report the long term use of subcutaneous somatostatin analogue SMS 201-995 in an elderly man presenting with severe watery diarrhoea and anaemia due to a pancreatic vipoma. Good symptomatic improvement has been achieved with no side effects over a period of 24 months. We suggest there is a use for subcutaneous SMS 201-995 in elderly patients with inoperable pancreatic gut hormone producing tumours with metastases and in those where surgery would carry a high operative risk.
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Selected References
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- Adrian T. E., Barnes A. J., Long R. G., O'Shaughnessy D. J., Brown M. R., Rivier J., Vale W., Blackburn A. M., Bloom S. R. The effect of somatostatin analogs on secretion of growth, pancreatic, and gastrointestinal hormones in man. J Clin Endocrinol Metab. 1981 Oct;53(4):675–681. doi: 10.1210/jcem-53-4-675. [DOI] [PubMed] [Google Scholar]
- Clements D., Elias E. Regression of metastatic vipoma with somatostatin analogue SMS 201-995. Lancet. 1985 Apr 13;1(8433):874–875. doi: 10.1016/s0140-6736(85)92235-4. [DOI] [PubMed] [Google Scholar]
- Dharmsathaphorn K., Sherwin R. S., Cataland S., Jaffe B., Dobbins J. Somatostatin inhibits diarrhea in the carcinoid syndrome. Ann Intern Med. 1980 Jan;92(1):68–69. doi: 10.7326/0003-4819-92-1-68. [DOI] [PubMed] [Google Scholar]
- Gerich J. E., Patton G. S. Somatostatin. Physiology and clinical applications. Med Clin North Am. 1978 Mar;62(2):375–392. doi: 10.1016/s0025-7125(16)31813-2. [DOI] [PubMed] [Google Scholar]
- Kraenzlin M. E., Ch'ng J. C., Wood S. M., Bloom S. R. Can inhibition of hormone secretion be associated with endocrine tumour shrinkage? Lancet. 1983 Dec 24;2(8365-66):1501–1501. doi: 10.1016/s0140-6736(83)90847-4. [DOI] [PubMed] [Google Scholar]
- Kraenzlin M. E., Ch'ng J. L., Wood S. M., Carr D. H., Bloom S. R. Long-term treatment of a VIPoma with somatostatin analogue resulting in remission of symptoms and possible shrinkage of metastases. Gastroenterology. 1985 Jan;88(1 Pt 1):185–187. doi: 10.1016/s0016-5085(85)80153-0. [DOI] [PubMed] [Google Scholar]
- Krejs G. J., Browne R., Raskin P. Effect of intravenous somatostatin on jejunal absorption of glucose, amino acids, water, and electrolytes. Gastroenterology. 1980 Jan;78(1):26–31. [PubMed] [Google Scholar]
- Long R. G., Barnes A. J., Adrian T. E., Mallinson C. N., Brown M. R., Vale W., Rivier J. E., Christofides N. D., Bloom S. R. Suppression of pancreatic endocrine tumour secretion by long-acting somatostatin analogue. Lancet. 1979 Oct 13;2(8146):764–767. doi: 10.1016/s0140-6736(79)92115-9. [DOI] [PubMed] [Google Scholar]
- Moertel C. G., Hanley J. A., Johnson L. A. Streptozocin alone compared with streptozocin plus fluorouracil in the treatment of advanced islet-cell carcinoma. N Engl J Med. 1980 Nov 20;303(21):1189–1194. doi: 10.1056/NEJM198011203032101. [DOI] [PubMed] [Google Scholar]
- Ruskoné A., René E., Chayvialle J. A., Bonin N., Pignal F., Kremer M., Bonfils S., Rambaud J. C. Effect of somatostatin on diarrhea and on small intestinal water and electrolyte transport in a patient with pancreatic cholera. Dig Dis Sci. 1982 May;27(5):459–466. doi: 10.1007/BF01295657. [DOI] [PubMed] [Google Scholar]
- Vale W., Brazeau P., Grant G., Nussey A., Burgus R., Rivier J., Ling N., Guillemin R. Premières observations sur le mode d'action de la somatostatine, un facteur hypothalamique qui inhibe la sécrétion de l'hormone de croissance. C R Acad Sci Hebd Seances Acad Sci D. 1972 Dec 18;275(25):2913–2916. [PubMed] [Google Scholar]
- Wood S. M., Kraenzlin M. E., Adrian T. E., Bloom S. R. Treatment of patients with pancreatic endocrine tumours using a new long-acting somatostatin analogue symptomatic and peptide responses. Gut. 1985 May;26(5):438–444. doi: 10.1136/gut.26.5.438. [DOI] [PMC free article] [PubMed] [Google Scholar]