胃肠间质瘤治疗新进展

New progress in the treatment for gastrointestinal stromal tumors

胃肠间质瘤(GISTs)是最常见的间叶源性肿瘤,外科手术是局限型无转移GISTs首选的治疗方式,但较多患者术后出现转移、复发。伊马替尼辅助治疗在防治肿瘤转移、复发方面发挥着重要作用,但其在用药剂量和用药时间等方面仍有不少争议,对于肿瘤体积较大、初始不可切除的GISTs,新辅助治疗是其可考虑的一个选择。舒尼替尼及瑞戈菲尼在二、三线治疗中发挥了重要作用,BLU-285为PDGFRA D842突变患者带来了希望,近年来兴起的免疫治疗在胃肠间质瘤中仍处于探索阶段。文章就GISTs的手术治疗、新辅助治疗、术后辅助治疗以及其他治疗措施等研究进行综述。

Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors.Surgery remains to be the primary treatment for patients with localized GISTs,but there are still many patients suffering from tumor metastasis and recurrence after surgery.Imatinib adjuvant therapy plays an important role in the prevention and treatment of tumor metastasis and recurrence,but there are still many controversies in terms of dosage and time of administration.For initial unresectable GISTs with large volume,neoadjuvant therapy may considered to be an option.Sunitinib and regorafenib have played an important role in the second and the third line treatments.BLU-285 has brought hope to patients with mutation of PDGFRA D842.The emerging immunotherapy is still in the exploration stage of gastrointestinal stromal tumors in recent years.This article reviews the research progress of surgical treatment,neoadjuvant therapy,postoperative adjuvant therapy and other treatments for GISTs.