Clinical application of traditional Chinese medicine in the treatment of neuroendocrine neoplasms

Abstract

Neuroendocrine neoplasms (NENs) are a group of rare tumors with strong heterogeneity. Among these tumors, well‐differentiated tumors can have a relatively good survival prognosis, while some tumors can have strong malignant potential and lead to increased mortality. Traditional Chinese medicine (TCM), which has a long history of thousands of years, has been widely used to treat tumors due to its unique advantages, such as economy, efficacy and few side effects. In recent years, the role of TCM in the treatment of NENs has gradually emerged. It can not only help prevent tumor recurrence and reduce the side effects of radiotherapy and chemotherapy but also relieve symptoms and improve quality of life. Various clinical studies have indicated that TCM has achieved good curative effects at different stages of treatment. We summarized the last 10 years of research progress on the clinical application of TCM in the treatment of NENs from four points of entry, aiming to provide a reference for the treatment of NENs.

Keywords

clinical application / neuroendocrine neoplasms / traditional Chinese medicine / treatment

References

[1] Dasari A , Shen C , Halperin D , et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. 2017 Oct 1; 3 (10): 1335- 1342.

[2] WHO Classification of Tumours Editorial Board . Digestive System Tumours. WHO Classification of Tumours. 5th ed. WHO; 2019: 16.

[3] Delle FG , O"Toole D , Sundin A , et al. ENETS consensus guidelines update for gastroduodenal neuroendocrine neoplasms. Neuroendocrinology. 2016; 103 (2): 119- 124.

[4] Merola E , Sbrozzi-Vanni A , Panzuto F , et al. Type I gastric carcinoids: a prospective study on endoscopic management and recurrence rate. Neuroendocrinology. 2012; 95 (3): 207- 213.

[5] Grozinsky-Glasberg S , Kaltsas G , Gur C , et al. Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours. Eur J Endocrinol. 2008; 159 (4): 475- 482.

[6] Khuroo MS , Khuroo MS , Khuroo NS . Treatment of type I gastric neuroendocrine tumors with somatostatin analogs. J Gastroenterol Hepatol. 2010; 25 (3): 548- 554.

[7] Campana D , Ravizza D , Ferolla P , et al. Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study. Endocrine. 2015; 51 (1): 1- 9.

[8] Sara Massironi Alessandra , Zilli A , Fanetti I , Ciafardini C , Conte D , Peracchi M . Intermittent treatment of recurrent type-1 gastric carcinoids with somatostatin analogues in patients with chronic autoimmune atrophic gastritis. Dig Liver Dis. 2015; 47 (11): 978- 983.

[9] Liu YY . Xiaoyao San Combined with Xiangsha Liujunzi Decoction in the Treatment of Type 1 Gastric Neuroendocrine Tumors. Beijing University of Chinese Medicine; 2015 (in Chinese).

[10] Zhang C . Clinicopathological Features and Traditional Chinese Medicine Treatment of Type 1 Gastric Neuroendocrine Tumors. Beijing University of Chinese Medicine; 2016 (in Chinese).

[11] Dou D , Qiu XD , Chen YY , et al. The clinical observation of modified Shumu Liujunzi Decoction for type 1 gastric neuroendocrine neoplasm. Chin Clin Oncol. 2019; 24: 824- 827 (in Chinese).

[12] Chen Y , Han D , Zhu J , et al. A prospective and retrospective clinical controlled observation of Chinese herbal decoction (SMLJ01) for type 1 gastric neuroendocrine tumors. Integr Cancer Ther. 2020; 19: 1534735420958488.

[13] Na WJ , Wei X . Effect of emotional therapy based on five element theory on female patients with type 1 gastric neuroendocrine tumors. J Mudanjiang Med Coll. 2019; 40 (03): 120- 122 (in Chinese).

[14] Fan JH , Zhang YQ , Shi SS , et al. A nation-wide retrospective epidemiological study of gastroenteropancreatic neuroendocrine neoplasms in China. Oncotarget. 2017 May 3; 8 (42): 71699- 71708.

[15] Bonney GK , Gomez D , Rahman SH , et al. Results following surgical resection for malignant pancreatic neuroendocrine tumours. A single institutional experience. JOP. 2008 Jan 8; 9 (1): 19- 25.

[16] Gomez-Rivera F , Stewart AE , Arnoletti JP , Vickers S , Bland KI , Heslin MJ , et al. Surgical treatment of pancreatic endocrine neoplasms. Am J Surg. 2007 Apr; 193 (4): 460- 465.

[17] Barrett JR , Rendell V , Pokrzywa C , et al. Adjuvant therapy following resection of gastroenteropancreatic neuroendocrine tumors provides no recurrence or survival benefit. J Surg Oncol. 2020 Jun; 121 (7): 1067- 1073.

[18] Li Y , Fan G , Yu F , Tian C , Tan H . Meta-analysis of prognostic factors for recurrence of resected well-differentiated pancreatic neuroendocrine tumors. Neuroendocrinology. 2021; 111 (12): 1231- 1237.

[19] Zhang P . Clinical Study of Traditional Chinese Medicine in Preventing Recurrence after Radical Resection of Highly Differentiated Pancreatic Neuroendocrine Tumors. Beijing University of Chinese Medicine; 2017 (in Chinese).

[20] Wang X . Clinical Study on Adjuvant Treatment of Well-Differentiated Pancreatic Neuroendocrine Tumors after Radical Resection with Traditional Chinese Medicine. Beijing University of Chinese Medicine; 2020 (in Chinese).

[21] Yu FH , Li YL , Su F , et al. A retrospective study on the prevention of postoperative recurrence of pancreatic neuroendocrine tumors with Qizhen Yiliu Fang. J China-Jpn Friendsh Hosp. 2023; 37 (01): 21- 24 (in Chinese).

[22] Gastrointestinal Hormone and Neuroendocrine Neoplasm Group , Chinese Society of Gastroenterology , Chinese Medical Association . Expert consensus on diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasm (2020, Guangzhou). Chin J Dig. 2021; 41 (2): 76- 87 (in Chinese).

[23] Li M , Dou D , Luo J , et al. Clinical observation on traditional Chinese medicine in combination with somatostatin analogues for advanced gastroenteropancreatic neuroendocrine tumors. Chin Clin Oncol. 2017; 22 (03): 238- 242 (in Chinese).

[24] Rinke A , Müller HH , Schade-Brittinger C , et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group. J Clin Oncol. 2009 Oct 1; 27 (28): 4656- 4663.

[25] Jann H , Denecke T , Koch M , Pape U , Wiedenmann B , Pavel M . Impact of octreotide long-acting release on tumour growth control as a first-line treatment in neuroendocrine tumours of pancreatic origin. Neuroendocrinology. 2013; 98 (2): 137- 143.

[26] Qiu XD . Clinical Study on Adjuvant Treatment of Highly Differentiated Pancreatic Neuroendocrine Tumors after Radical Resection with Traditional Chinese Medicine. Beijing University of Chinese Medicine; 2019 (in Chinese).

[27] Yu MM , Zhang RF , Chen HL , et al. Long acting octreotide combined with brain tonifying and kidney tonifying drugs in the treatment of gastrointestinal neuroendocrine tumors. Chin J Tradit Med Sci Technol. 2014; 21 (06): 676- 677 (in Chinese).

[28] Guidelines of Chinese Society of Clinical Oncology (CSCO) Neuroendocrine Neoplasms. People's Medical Publishing House, Guidelines Committee of Chinese society of Clinical Oncology, 2021 (in Chinese).

[29] Sorbye H , Welin S , Langer SW , et al. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): the NORDIC NEC study. Ann Oncol. 2013 Jan; 24 (1): 152- 160.

[30] Wang JJ , Zhang J , Chen XX , et al. A meta-analysis of bone marrow suppression after chemotherapy in malignant tumors treated with traditional Chinese Medicine. Lishizhen Med Mater Med Res. 2020; 31 (2): 485- 489 (in Chinese).

[31] Zhang YH , Liu XW , Chang YP . Traditional Chinese medicine treatment for uterine neuroendocrine cancer: a case report. World Latest Med Infor. 2017; 17 (98): 150 (in Chinese).

[32] Xu L , Huang JC . A case of mediastinal neuroendocrine carcinoma treated with traditional Chinese Medicine. J China-Jpn Friendsh Hosp; 2008 (05): 314 (in Chinese).

RIGHTS & PERMISSIONS

2024 The Author(s). Advanced Chinese Medicine published by John Wiley & Sons Australia, Ltd on behalf of Higher Education Press.