苹果酸舒尼替尼二线治疗37例晚期胃肠间质瘤的临床研究  

Sunitinib Malate as Second-line Therapy for Advanced Gastrointestinal Stromal Tumor:An Analysis of 37 Cases

作　　者：范立侨[1] 夏宇翔 檀碧波[1] 赵群[1] 刘羽[1] 赵雪峰[1] 张志栋[1] 李勇[2] FAN Li-qiao;XIA Yu-xiang;TAN Bi-bo;ZHAO Qun;LIU Yu;ZHAO Xue-feng;ZHANG Zhi-dong;LI Yong(The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院,河北石家庄050011 [2]河北医科大学第四医院外三科,河北石家庄050011

出　　处：《肿瘤学杂志》2021年第6期455-458,共4页Journal of Chinese Oncology

基　　金：河北省科技厅课题(14277751D)。

摘　　要：[目的]探讨苹果酸舒尼替尼二线治疗晚期胃肠间质瘤(GIST)患者的临床疗效及其不良反应。[方法]选取河北医科大学第四医院应用苹果酸舒尼替尼二线治疗的37例晚期胃肠间质瘤患者的临床资料,进行回顾性分析,按Choi标准进行疗效评估。[结果] 37例患者共接受苹果酸舒尼替尼治疗701个月,平均18.9个月。治疗后PR 4例(10.8%)、SD 17例(45.9%)、PD 16例(32.4%),总体客观有效率(ORR)为10.8%,疾病控制率(DCR)为56.8%。不良反应多为1~2级,3~4级较少,无5级不良反应。肝转移组中位无进展生存期(PFS)为18.0个月,较腹腔转移组(8.5个月)明显增加(P<0.05);c-kit外显子11突变组PFS为14.0个月,较外显子9突变组(15.0个月)降低(P<0.05)。[结论]苹果酸舒尼替尼二线治疗GIST可提高DCR,延长PFS,其对单纯肝转移者及c-kit 9外显子突变者疗效更加显著,不良反应可耐受。[Objective] To investigate the clinical efficacy and safety of sunitinib malate as second-line therapy for patients with advanced gastrointestinal stromal tumor(GIST). [Methods] The clinical data of37 patients with advanced GIST treated with sunitinib malate as second-line therapy in the Fourth Hospital of Hebei Medical University from January 2003 to December 2018 were retrospectively analyzed.The efficacy was evaluated according to Choi standard. [Results] Patients received the treatment of sunitinib malate with an average of 18.9 months. There were 4 cases of PR(10.8%),17 cases of SD(45.9%) and 16 cases of PD(32.4%). The overall objective response rate(ORR) was 10.8%,and the disease control rate(DCR) was 56.8%. The adverse drug reactions were mostly grade 1~2,and no grade 5 adverse drug reactions was observed. The PFS of liver metastasis group was significantly higher than that of abdominal metastasis group(18.0 months vs 8.5 months,P <0.05);the PFS of c-kit exon 11 mutation group was lower than that of exon 9 mutation group(14.0 months vs 15.0 months,P<0.05). [Conclusion]Sunitinib malate may improve DCR and prolong PFS in patients with advanced GSIT. The curative effect is more significant in patients with simple liver metastasis and c-kit exon 9 mutation,and adverse reactions are tolerable.

关 键 词：胃肠间质瘤 苹果酸舒尼替尼 无进展生存期 总生存期 不良反应 

分 类 号：R730.262[医药卫生—肿瘤]