This protocol addresses the well-differentiated gastric neuroendocrine tumor (NET) arising in the gastrointestinal tract — a distinct entity from poorly differentiated neuroendocrine carcinoma, with a different classification and management approach.
The patient presents with a well-differentiated gastric NET of the gastrointestinal tract. Per the WHO Classification of Endocrine Organs (2017) and Digestive System (2019), this tumor is categorized as a well-differentiated NET — explicitly distinguished from poorly differentiated neuroendocrine carcinoma (NEC). That distinction drives the treatment pathway.
Management involves peptide-based radionuclide therapy, among other modalities. Radiation-based strategies also have a role in certain metastatic presentations.
The WHO Classification of Endocrine Organs (2017) and Digestive System (2019) categorizes NENs as well-differentiated NENs (termed "NETs") or poorly differentiated NECs.
Furthermore, radiation therapy may be used for palliative purposes for bone and brain metastases.
Radionuclide-labeling peptide therapy (PRRT) is often used in Europe and the U.S.
PRRT has recently been covered by insurance in Japan, but at present, it should be given priority to patients who are ineffective with other drugs after the second treatment and need immediate PRRT treatment.
DOI: 10.1007/s00535-021-01827-7
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