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

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.