Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are increasingly recognized, characterized by prolonged survival even with metastatic disease. Their medical treatment is complex involving various specialties, necessitating awareness of treatment-related adverse effects (AEs). As GEP-NENs express somatostatin receptors (SSTRs), long-acting somatostatin analogs (SSAs) that are used for secretory syndrome and tumor control may lead to altered glucose metabolism. Everolimus and sunitinib are molecular targeted agents that affect glucose and lipid metabolism and may induce hypothyroidism or hypocalcemia, respectively. Chemotherapeutic drugs can affect the reproductive system and water homeostasis, whereas immunotherapeutic agents can cause hypophysitis and thyroiditis or other immune-mediated disorders. Treatment with radiopeptides may temporarily lead to radiation-induced hormone disturbances. As drugs targeting GEP-NENs are increasingly introduced, recognition and management of endocrine-related AEs may improve compliance and the quality of life of these patients.

中文翻译：

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继发于胃肠胰腺神经内分泌肿瘤 (GEP-NEN) 治疗的内分泌毒性

胃肠胰腺神经内分泌肿瘤 (GEP-NEN) 越来越受到认可，其特征是即使转移性疾病也能延长生存期。他们的医疗是复杂的，涉及各种专业，需要了解与治疗相关的不良反应 (AE)。由于 GEP-NEN 表达生长抑素受体 (SSTR)，用于分泌综合征和肿瘤控制的长效生长抑素类似物 (SSAs) 可能会导致葡萄糖代谢改变。依维莫司和舒尼替尼是影响葡萄糖和脂质代谢的分子靶向药物，可能分别诱发甲状腺功能减退或低钙血症。化疗药物会影响生殖系统和体内水分平衡，而免疫治疗药物会引起垂体炎和甲状腺炎或其他免疫介导的疾病。用放射性肽治疗可能会暂时导致辐射诱发的激素紊乱。随着越来越多的针对 GEP-NEN 的药物被引入，内分泌相关 AE 的识别和管理可能会提高这些患者的依从性和生活质量。