Background and aims: Long-acting somatostatin analogues (SAs) are an established treatment for functional symptoms of neuroendocrine tumours (NETs) and also for their known anti-tumour effect. Discussion with colleagues highlighted variations in their use in practice, surrounding test-dosing and treatment doses of SAs.
Methods: In 2016 an electronic survey of SA use was undertaken to illuminate actual practice in the UK. Questions focused on test-dosing, treatment doses of SAs, monitoring tests whilst on treatment and rationale for choice of SA, both to manage functional NET symptoms and also non-functional NETs (use as anti-tumour therapy).
Results: In total, 21 different hospitals across the UK responded to the survey. Findings highlighted wide variation in practice in a number of key areas; the use of test dosing prior to establishing SAs; a range of different SA treatment doses, and variation in monitoring tests whilst on treatment. Practice variation existed both in managing functional symptoms, but also when used as anti-tumour therapy. Despite a wide range of test dosing regimes, there were very few recorded drug reactions and it was extremely rare not to establish patients on an SA after test dosing.
Conclusions: This survey highlights wide variation in practice in terms of test dosing, drug dosing and monitoring tests. It raises a number of practice questions; should detailed guidance exist; are all these practices justified and what are the cost/resource implications. Future projects include a possible multicentre audit of test-dosing and monitoring of patients on SAs. Consideration could also be given to a European wide survey of SA use.
05 Dec 2016
UK and Ireland Neuroendocrine Tumour Society