선암 이외의 진행성 폐암에 대한항암화학요법 및 표적 치료 - 신경내분비암
Chemotherapy and Targeted Therapy beyond Adenocarcinoma of the Lung: Neuroendocrine Carcinoma
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초록
소세포폐암을 제외한 신경내분비종양은 크게 유암종과 대세포신경내분비종양으로 분류할 수 있다. 유암종의 경우는 주로 수술적 치료가 근간을 이루고 있으나 일부에서는 재발하거나 전이가 될 수 있으며, 이런 경우 증상의 조절과 질병 조절을 위한 적절한 치료를 선택하는 것이 중요하다. 대세포신경내분비종양의 경우 과거에 비해 진단기술이 발전하면서 유병률이 증가하였으나 아직도 진단에는 어려움이 있으며 또한적절한 치료가 확립되지 않았다. 현재 진행 중인 연구를 비롯하여 신경내분비종양의 특성을 반영하여 예후를 향상시킬 수있는 연구가 필요한 실정이다.
Abstract
Neuroendocrine carcinoma (NEC) has been reported to comprise 25% of lung cancer cases. NEC is classified as typical carcinoid, atypical carcinoid, large-cell neuroendocrine carcinoma, and small-cell lung cancer. Carcinoid tumors are less aggressive and surgery is the mainstay of treatment; however, patients with metastatic or inoperable disease need systemic therapy to control carcinoid symptoms and improve survival. Somatostain analogues, targeted agents including everolimus, sunitinib, bevacizumab, and conventional chemotherapy have emerged as treatment options for such patients. Large-cell neuroendocrine carcinoma exhibits more aggressive behavior and has a poorer prognosis than carcinoid tumors. No standard adjuvant and palliative chemotherapeutic agents have yet been established. This review sets out the treatment options for neuroendocrine tumors.
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