胃肠道间质瘤术后应用伊马替尼辅助治疗分析

Analysis of adjuvant post-surgical therapy with imatinib in gastrointestinal stromal tumor

目的:探讨伊马替尼术后辅助治疗胃肠道间质瘤的临床效果,分析其对预后的影响。方法:回顾性分析47例经手术治疗的胃肠道间质瘤患者的临床资料,采用Kaplan-Meier法进行预后的生存分析,并采用Cox比例风险模型进行多因素分析。结果:1)术后32例患者接受伊马替尼辅助治疗,术后1、3、5年存活率分别为72.3%、51.0%和34.0%。2)性别及间质瘤部位的不同对存活率差异无影响(P>0.05)。而肿瘤直径、不同核分裂像、危险度分级、手术方式、伊马替尼治疗与存活率相关(P<0.05)。多因素分析显示肿瘤直径、核分裂数、危险度、是否行完全切除以及是否予伊马替尼治疗影响患者预后存活率(P<0.05)。3)绝大部分患者耐受良好,不良反应程度较轻,多数为一过性或具有自限性,包括水肿、消化道反应和贫血。结论:应用伊马替尼术后辅助治疗的患者生存期更长,且不良反应较少,临床使用安全性高。

Objective： to explore the clinical effect of adjuvant post-surgical therapy with Imatinib in gastrointestinal stromal tumor（GIST）,and analyze its influence on prognosis.Methods： the 41 GIST patients＇ data were retrospectively reviewed,Kaplan-Meier and Cox proportion hazards regression model were used to analyze.Results： 1）32 GIST patients received adjuvant post-surgical therapy with imatinib,the 1-year,3-year and 5-year total survival rate respectively was 72.3%, 51.0% and 34.0%.2）Tumor risk classification showed that tumor size,mitotic count,classification, surgical procedure,treatment with Imatinib was relevant to postoperational survival rate（P0.05）. Multivariate analyses showed that tumor size,mitotic count,classification,surgical procedure,treatment with Imatinib were independent prognostic factors.3）The most common adverse effects of imatinib included edema,gastrointestinal reaction and anemia,and most were temporality.Conclusion： Imatinib was most effective in treating GIST patients and the adverse effects were receivable.