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Welcome to Dr. Hamid Sanatinia's Virtual Headquarters
Carcinoid

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Should we treat or not???
Performace Status
Antiemetics
Growth Factors
Calculations
Chemo Precautions
TOXICITY CRITERIA
Antidepressants
Chemoprotection
MESNA
Dexrazoxane
Radioprotectants
Hypercalcemia of malignancy
Mucositis
Neutropenic Fever
Palliative Care
Radiation Oncology
<<<<<<<<<>>>>>>>>>
ALL
AML
Anal
Bladder Cancer
Brain Cancer
Breast (risk category)
Breast (adjuvant)
Breast (metastatic)
Breast (Xeloda)
Breast (hormonal)
Breast Cancer Genetics
Carcinoid
CLL
CML
COLON CANCER
Endometrial
Esophagous
Gastric
Gestational Trophoblastic Disease
Germ Cell (Ovary)
Hairy Cell Leukemia
Head/Neck
Head/Neck: ChemoRT abstracts
Head/Neck: Larynx
Head/Neck:Nasopharyngeal
Hodgkins
Islet Cell Tumors
Kidney
Liver
LUNG, NSC
Stage III Unresectable NSC Lung Cancer
Lung, SC
Lymphoma, Aggressive
Lymphoma, AIDS
Lymphoma, Burkitts
Lymphoma, CNS
Lymphoma, Cutaneous
Lymphoma, Indolent
Lymphoma, MALT
Lymphoma, Mantle cell
Lymphoma, Mediastinal B-Cell
Lymphoma, Refractory NHL
Melanoma
Mesothelioma
Multiple Myeloma
MDS
NHL
Ovarian
Pancreas
Prostate
Prostate (Hormonal)
Rectal Cancer
Sarcoma
Sarcoma, Ewing's
Sarcoma, Osteogenic
Skeletal Metastasis
Testicular Cancer
Thymoma
Thyroid Cancer
Waldenstrom's
Unknown Primary
<<<<<<<<<>>>>>>>>>
Molecular Genetics
Oncogenes, the list!
Immunoperoxidase stains
Tumor Markers
Bleomycin
Cisplatin
Etoposide
Ifosfamide
Methotrexate
Temazolamide
Mechanism of Action
Dose Modifications (Renal)
Dose Modifications (hepatic)
MDR

Treatment:
Surgery
Radiation Therapy
Chemotherapy (tend to be resistant)
Symptomatic Treatment


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Single Agent Chemotherapy
5FU
Doxorubicin
IFN-alpha 2a
IFN-aplpha 2b

Response rates with these agents are in the range of 10-20%, responses are <6 months in duration, & complete remissions are rare!

Combination Chemotherapy

Only marginal efficacy vs single agents!
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Treatment of Symptoms

Somatostatin analogues

OCTREOTIDE ACETATE (SANDOSTATIN)
100-600 ug/d SC/IV in 2-4 divided doses (titrate to symptoms)
For diarrhea associated with VIPomas:
200-300 ug/day SC/IV in 2-4 divided doses

Side effects: Chronic treatment may be associated with cholelithiasis, increased fecal fat excretion, fluid retention, nausea, & glucose intolerance.
Occasional objective responses have been observed in patients who have received octreotide.
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LONG-ACTING OCTREOTIDE
SANDOSTATIN LAR
Monthly injections


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