术前伊马替尼治疗对局部进展胃肠道间质瘤的远期疗效  

Long-term effect of neoadjuvant imatinib for locally advanced gastrointestinal stromal tumor

作　　者：林振孟 严明芳 王益[1] 魏晟宏[1] 宋锦添 龚麒麟[1] 陈路川[1] 郑辉哲[1] Lin Zhenmeng;Yan Mingfang;Wang Yi;Wei Shenghong;Song Jintian;Gong Qilin;Chen Luchuang;Zheng Huizhe(Department of Gastrointestinal Surgery,Fujian Cancer Hospital,Affiliated Cancer Hospital of Fujian MedicalUniversity,Fuzhou 350014,China)

机构地区：[1]福建省肿瘤医院福建医科大学附属肿瘤医院胃肠外科,福州350014

出　　处：《中华普通外科杂志》2019年第4期315-318,共4页Chinese Journal of General Surgery

基　　金：福建省卫生计生科研人才培养项目资助(2017-1-13).

摘　　要：目的 评估局部进展的胃肠道间质瘤患者术前服用伊马替尼的安全性及远期价值.方法 回顾性分析2009年9月至2016年11月于福建医科大学附属肿瘤医院术前口服伊马替尼34例局部进展胃肠道间质瘤患者的临床病理资料.结果 本组34例患者术前经伊马替尼治疗的中位时间为27周(12 ~71周).22例(65%)患者部分缓解,12例(35%)患者疾病稳定.所有手术患者术后病理均达到R0切除,手术并发症发生率为9%(3例),术后30 d内无死亡病例.术后20例患者继续口服伊马替尼治疗,14例患者术后未口服伊马替尼治疗.中位随访时间62.2个月(13~ 89个月).所有患者的3年总生存率为67%.单因素分析显示:肿瘤位置、术前疗效评估、术后病理反应、术后是否继续靶向治疗是影响患者预后的危险因素;多因素分析显示:肿瘤位置、术后病理反应、术后是否继续靶向治疗是影响患者预后的独立危险因素.结论 局部进展胃肠道间质瘤患者术前服用伊马替尼安全有效,可使肿瘤缩少从而提高手术切除率.Objective To explore the safety and long-term results of preoperative imatinib mesylate administration (IM) in patients with locally advanced gastrointestinal stromal tumors (GIST).Methods From Sep 2009 to Nov 2016,locally advanced GIST patients treated in Fujian Medical University Cancer Hospital were analysed retrospectively.Result 34 patients were included.Preoperative median IM treatment was 27 weeks(range 12-71 weeks).65% patients had a partial response to IM,35% showed stable disease.All patients underwent surgical R0 resection.The complication rate was 9% and no death occurred within 30 days post operation.The median follow-up time was 62.2 months (range of 13-89 months).20 patients continued to take imatinib orally,14 patients did not.The 3 year survival rate of patients undergoing surgery was 67%.Univariate analysis showed that tumor location,preoperative imatinib effect,pathology,targeted therapy after surgery were factors affecting prognosis.Multivariate analysis show that the independent risk factors affecting prognosis were tumor location,pathology,targeted therapy after surgery.Conclusion In locally advanced GISTs,preoperative IM is useful and safe that can effectively decrease tumor size,facilitating resection.

关 键 词：胃肠道间质肿瘤 分子靶向治疗 伊马替尼 

分 类 号：R735[医药卫生—肿瘤]