Russian Journal of OncologyRussian Journal of OncologyРоссийский онкологический журнал1028-99842412-9119Eco-Vector64273410.17816/onco642734JONKLFReviewsНаучные обзорыReview ArticleCurrent Management Strategies for Patients with Gastrointestinal and Pulmonary Neuroendocrine TumorsСовременные алгоритмы ведения пациентов с нейроэндокринными опухолями желудочно-кишечного тракта и лёгкихhttps://orcid.org/0009-0009-2644-31022298-1810MikheevaYulia V.МихееваЮлия Вадимовна
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

Yuliya.mikheeva64@gmail.comhttps://orcid.org/0000-0002-7721-634X7085-7976RumyantsevPavel O.РумянцевПавел Олегович
Russian Federation

MD, Dr. Sci. (Medicine)

д-р. мед. наук

pavelrum@gmail.comhttps://orcid.org/0000-0001-8784-895X5800-6834PuzakovKonstantin K.ПузаковКонстантин Константинович
Russian Federation
k_kovalchik@mail.ruhttps://orcid.org/0000-0002-3220-24383079-8033SlashchukKonstantin Yu.СлащукКонстантин Юрьевич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

slashuk911@gmail.comhttps://orcid.org/0000-0002-2788-23526398-0656OmelchukDaniil D.ОмельчукДаниил Давидович
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

lebedevldd@gmail.comhttps://orcid.org/0000-0001-8903-73256774-4710PotapenkoAnastasia V.ПотапенкоАнастасия Витальевна
Russian Federation
osipchukanastasiia@gmail.comhttps://orcid.org/0009-0008-2395-31696815-3714MedvedevSergey P.МедведевСергей Петрович
Russian Federation
feelyou2017@mail.ruTreatment and Rehabilitation CentreЛечебно-реабилитационный центрBELOOSTROV Clinic of High TechnologiesКлиника высоких технологий «Белоостров» ММЦ-ВТEndocrinology Research CentreНациональный медицинский исследовательский центр эндокринологииDoctor 03ООО «Доктор 03»120620252306202530141601012202423052025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://rjonco.com/1028-9984/article/view/642734

Neuroendocrine tumors (NETs) of the gastrointestinal tract and lungs are rare yet clinically significant neoplasms characterized by heterogeneous progression and diverse manifestations. This article systematizes current management strategies based on the latest recommendations and scientific advances. Epidemiological trends are a key focus, including an increase in NET incidence rates over the past few decades (6.4 times in the USA from 1973 to 2012) and the predominance of gastroenteropancreatic NETs (62–70%) and bronchopulmonary NETs (25%). The following key clinical aspects are highlighted, including hormonally active conditions (carcinoid syndrome, gastrinomas, insulinomas) and their complications (carcinoid heart disease and crises). Current approaches to diagnose, treatment, and monitoring of NETs are discussed using recent guidelines and scientific data. Molecular genetic testing is emphasized because of its ability to improve risk stratification and personalize treatment. The following treatment options are discussed: surgery (resection, liver transplantation); pharmacotherapy (somatostatin analogues, telotristat, and targeted therapies such as sunitinib and everolimus); chemotherapy; peptide receptor radionuclide therapy. The key study outcomes are presented. The article also addresses challenges in early diagnosis and the need for a multidisciplinary approach and personalized treatment. Promising areas of using novel biomarkers and imaging techniques are mentioned, and the importance of follow-up is emphasized, including follow-up intervals and watch and wait strategies for small tumors. The article discusses the challenges of early diagnosis and the importance of thorough tumor evaluations and explores prospects for further research to optimize treatment strategies.

Нейроэндокринные опухоли желудочно-кишечного тракта и лёгких представляют собой редкую, но клинически значимую группу новообразований, характеризующихся гетерогенным течением и разнообразием клинических проявлений. В статье систематизированы современные алгоритмы ведения пациентов с учётом последних рекомендаций и научных достижений. Значительное внимание уделено эпидемиологическим тенденциям: рост заболеваемости нейроэндокринными опухолями за последние десятилетия (в 6,4 раза в США с 1973 по 2012 гг.), преобладание гастроэнтеропанкреатических (62–70%) и бронхолёгочных (25%) локализаций. Особый акцент сделан на ключевых клинических аспектах, включая гормонально-активные формы (карциноидный синдром, гастриномы, инсулиномы) и их осложнения (карциноидная болезнь сердца, кризы). В настоящей статье рассмотрены современные подходы к диагностике, лечению и мониторингу таких пациентов с учётом последних рекомендаций и научных данных. Особое внимание уделено молекулярно-генетическим исследованиям, позволяющим улучшить стратификацию рисков и персонализацию терапии. В разделе лечения детально проанализированы хирургические методы (резекция, трансплантация печени), лекарственная терапия (аналоги соматостатина, телотристат, таргетные препараты — сунитиниб, эверолимус), химиотерапия и пептидная рецепторная радионуклидная терапия. Приведены результаты ключевых исследований. Отдельно освещены сложности ранней диагностики, необходимость мультидисциплинарного подхода и персонализации лечения. Подчёркнуты перспективы применения новых биомаркеров и методов визуализации, а также важность диспансерного наблюдения (интервалы обследования, стратегия «watch and wait» для малых опухолей). Обсуждаются сложности ранней диагностики, необходимость комплексной оценки опухолевого процесса и перспективы дальнейших исследований для оптимизации стратегий лечения.

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