小肠胃肠间质瘤术后腹腔内广泛转移多学科综合诊治一例  

A case of multidisciplinary team treatment of intestinal gastrointestinal stromal tumors with post-operative abdominal metastasis

作　　者：何佳炜 赵亚梅 王健[1,2] 王展怀[1,2] 葛晓旭[1,2] 孔祥兴 王六红[3] 王超[3] 袁瑛[2,4] 丁克峰[1,2] 张苏展[1,2] 孙立峰[1,2] He Jiawei;Zhao Yamei;Wang Jian;Wang Zhanhuai;Ge Xiaoxu;Kong Xiangxing;Wang Liuhong;Wang Chao;Yuan Ying;Ding Kefeng;Zhang Suzhan;Sun Lifeng(Department of Surgical Oneology,The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;Cancer Institute,Key Laboratory of Cancer Prevention and Intervention of China National Ministry of Education,The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Radiology,The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Medical Oneology,The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院肿瘤外科,浙江杭州310009 [2]浙江大学大肠癌诊治中心暨恶性肿瘤预警与干预教育部重点实验室,浙江杭州310009 [3]浙江大学医学院附属第二医院放射科,浙江杭州310009 [4]浙江大学医学院附属第二医院肿瘤内科,浙江杭州310009

出　　处：《实用肿瘤杂志》2018年第5期391-396,共6页Journal of Practical Oncology

基　　金：国家自然科学基金面上项目(81472819)

摘　　要：本文介绍1例原发灶切除术后7年出现腹腔转移的小肠胃肠间质瘤后续的诊治经过。患者11年前因消化道出血行小肠肿物切除术,术后病理确诊为胃肠道间质瘤。4年前患者因出现腹腔转移开始口服伊马替尼(400 mg/d),27个月后疾病进展。经多学科专家组讨论后,患者选择行伊马替尼增量(600 mg/d)继续治疗,但5个月后疾病再次进展;患者遂改用舒尼替尼(37.5 mg/d)继续治疗。2个月后腹腔转移灶明显进展,经多学科专家组再次讨论,患者接受开腹腹腔肿瘤细胞减灭术。患者术后继续口服舒尼替尼,从初次复发至今,已获得52个月的生存时间。This article describes the treatment for postoperative intra-abdominal metastasis from small intestinal gastrointestinal stromal tumors. The patient was diagnosed with gastrointestinal stromal tumors after a resection surgery 11 years ago. In 2014 he developed abdominal metastasis identified by pelvic tumor biopsy and had been treated with imatinib（ 400 mg/d） for 27 months before tumor progression. After the first multidisciplinary team（ MDT） discussion,the patient accepted incremental dose of imatinib therapy（ 600 mg/d） for 5 months and demonstrated progressive disease（ PD）. Then he received a second line therapy of sunitinib（ 37. 5 mg/d） for 2 months till PD. Subsequently,with MDT discussion,the patient underwent a cytoreductive surgery and then was treated with sunitinib again. Since then there has been no evidence of recurrence and the patient already has a 52-month overall survival since the first recurrence.

关 键 词：胃肠间质瘤 复发转移 伊马替尼 舒尼替尼 肿瘤减灭术 多学科诊治 

分 类 号：R735[医药卫生—肿瘤]