67例胃肠道间质瘤患者伊马替尼辅助治疗的临床观察

Clinical Observation of 67 Cases of Gastrointestinal Stromal Tumor Patients Treated with Imatinib Adjuvant Therapy

目的：探讨胃肠道间质瘤（GIST）伊马替尼辅助治疗的临床疗效。方法收集青岛市市立医院及川北医学院附属医院2007年1月至2012年12月间共67例手术切除的胃肠道间质瘤患者临床及随访资料进行回顾性分析。结果39例局限性患者在随访期间未发生确切转移性病灶；28例转移患者中，伊马替尼治疗2～3个月后临床及影像学评价：部分缓解6例，稳定14例，病情进展8例，其中3例患者对伊马替尼耐药，治疗期间病情持续进展，追加剂量后病情仍未控制，后患者放弃治疗，3～6个月后患者死亡。另5例患者在开始治疗6~12个月内病情稳定，后出现病情进展，在追加剂量后未能控制病情，患者行姑息性手术部分切除进展病灶后继续行伊马替尼治疗，患者病情稳定。结论胃肠道间质瘤伊马替尼辅助治疗能改善患者的愈后，长期使用伊马替尼的患者肿瘤复发率较低，且多数不良反应患者可以耐受。对于高风险的GIST患者推荐手术结合伊马替尼长期维持治疗。

Objective To investigate the GIST adjuvant imatinib clinical efifcacy. Methods Collected the patients treated in our hospital during January 2007 to December 2012. Among 67 cases of surgical resection of GIST patients and follow-up clinical data were retrospectively analyzed. Results 39 cases of limitations showed no sign metastatic lesions;28 cases of multiple metastases patients, 2-3 months after the therapy clinical and radiographic evaluation：some remission in 6 cases, stable in 14 cases, 8 cases of disease progression , including 3 case of imatinib-resistant patients, the disease continued to progress during treatment, an additional dose did not controlled the disease, the patients dead 3-6 months later. The other ifve patients starting treatment within 6-12 months in stable condition, then the dose failed to control the disease, patients underwent palliative surgery after partial resection of lesions and continued the therapy, no obvious signs of metastasis. Conclusion Imatinib adjuvant therapy can improve the prognosis of patients with GIST;long-term use of imatinib can lower the recurrence, and most patients can tolerate adverse reactions. For high-risk GIST patients, recommended palliative surgery and long-term maintenance therapy.