MODERN ASPECTS OF CARCINOID BRONCHOPULMONARY TUMOURS DIAGNOSIS AND TREATMENT

Abstract

Introduction. Neuroendocrine tumors (NET) of the lung represent a heterogeneous group of malignancies, that include typical, atipical carcinoid, large cell lung cancer and smal cell lung cancer. There has been an uptrend in the incidence of lung NETs during pasts decades. However, bronchopulmonary carcinoids are a rare group of tumors. Given the paucity of incidence, rational diagnosis and treatment is challenging. This paper provides an overview of the issue of diagnosis and treatment of lung carcinoid tumors. Aim. To highlight the managament of bronchopulmonary carcinoid based on guidelines and clinical studies. Materials and methods. The search and selection of publications, systematic reviews and guidelines were performed using the PubMed and Google Scholar databases. Results. The search yielded a significant number of publications, but the studies are mostly retrospective and cohort. Randomized trials concern the problem of treatment of metastatic carcinoid tumors. Recommendations of diagnostic and treatment are presented by guidelines – NCCN, NANETS, ENETS, ESMO. Surgical resection is the standard of care for early-stage lung carcinoids, in advanced case decisions are made using a multidisciplinary approach. We also discuss the management of metastatic lung NETs. Conclusions. Carcinoid lung tumors are rare types of neoplasms. Differential criteria for carcinoid lung tumors are morphological features, and immunohistochemical markers have additional role. The most effective method of non-invasive diagnosis is PET/CT with 68Ga-DOTA-octreotate, the use of 18F-deoxyglucose is less effective due to the low metabolic activity of most tumors. Surgical resection is the method of choice and provides a good prognosis, with 5-year survival for typical and atypical carcinoids being 90% and 70%, respectively. In the case of advance tumors and distant metastasis of the tumor, it is worth considering the use of somatostatin analogs and mTOR inhibitors.