甲磺酸伊马替尼治疗中晚期高危胃肠间质瘤的疗效和安全性分析

Analysis of efficacy and safety of imatinib mesylate in treatment of high risk gastrointestinal stromal tumor in middle and advanced stage

目的分析甲磺酸伊马替尼治疗中晚期高危胃肠间质瘤的疗效和安全性。方法回顾2008年10月-2014年10月到武汉商职医院诊治的中晚期高危胃肠间质瘤患者共96例,根据甲磺酸伊马替尼治疗时间分为两组,观察组48例患者治疗时间≥3年,对照组48例患者治疗时间<3年,比较两组患者疗效。结果观察组患者1、2、3、4、5年无进展生存率均明显高于对照组,差异有统计学意义(P<0.05)。性别、年龄和治疗时间是影响甲磺酸伊马替尼治疗有效率的重要因素(P<0.05)。治疗后观察组患者血清基质金属蛋白酶-9(MMP-9)蛋白及蛋白酶激活受体(PAR-2)mRNA水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者血细胞减少、肝肾功能受损、胃肠道反应、乏力及皮肤黏膜水肿等不良反应发生率均未表现出明显差异。结论延长甲磺酸伊马替尼治疗时间至3年以上能够有效提高中晚期高危胃肠间质瘤患者无进展生存率,且不良反应发生率并未明显升高,安全性好,建议临床推广应用。

Objective To analyze the efficacy and safety of imatinib mesylate in treatment of high risk gastrointestinal stromal tumor in middle and advanced stage.Methods 96 patients diagnosed with high risk gastrointestinal stromal tumor in middle and advanced stage in our hospital from October 2008 to October 2014 were involved in this research. They were randomly divided into two groups according to treatment time of imatinib mesylate. Treatment time of 48 patients in observation group was more than 3 years,and treatment time of 54 patients in control group was less than 3 years. Efficacy was compared in two groups.Results Progressionfree survival rates at 1, 2, 3, 4 and 5 years of patients in observation group were significantly higher than those in control group, and gender, age and treatment time were factors that affect response rate(P < 0.05). After treatment, levels of serum MMP-9 protein and PAR-2 mRNA in observation group were significantly lower than those in control group(P < 0.05). Adverse reaction incidences of hypocytosis, damage of liver and kidney function, gastrointestinal reaction, debilitation and edema of skin mucous membrane in two groups during treatment showed no obvious difference. Conclusion Prolonged time of imatinib mesylate in treatment of high risk gastrointestinal stromal tumor in middle and advanced stage to more than 3 years can effectively improve progression-free survival rate, with no significantly increased adverse reaction incidence, and recommend clinical popularization and application.