舒尼替尼联合腹腔镜手术预防胃肠道小间质瘤术后复发临床评价

Sunitinib Combined with Laparoscopy on Recurrence of Small Gastrointestinal Stromal Tumor

目的探讨舒尼替尼联合腹腔镜手术对胃肠道小间质瘤术后复发情况的影响。方法选取琼海市人民医院2015年至2017年收治的胃肠道小间质瘤患者90例,随机分为观察组和对照组,各45例。两组患者均予腹腔镜手术,观察组患者术后加服苹果酸舒尼替尼胶囊,每次50 mg,每日1次,连续服药4周、停药2周为1个周期,连续治疗3个周期。随访24个月。结果治疗后,观察组患者的癌抗原19-9(CA19-9)、癌胚抗原(CEA)、癌抗原125(CA125)水平及血管内皮生长因子(VEGF)、血小板源生长因子(PDGF)、集落刺激因子-1(CSF-1)水平均明显低于对照组(P<0.05);治疗期间,观察组与对照组不良反应发生率相当(17.78%比11.11%,P>0.05);观察组复发率、远端转移率、再手术率和死亡率均明显低于对照组(P<0.05)。结论舒尼替尼联合腹腔镜手术治疗胃肠道小间质瘤,能明显降低患者肿瘤标志物水平和促血管生成因子水平,降低复发率,远期疗效较好。

Objective To study the effect of sunitinib combined with laparoscopy on the recurrence of small gastrointestinal stromal tumor. Methods A total of 90 patients with small gastrointestinal stromal tumor in the hospital from January 2015 to December 2017 were selected and randomly divided into the observation group and control group,45 cases in each group. Both groups were treated with laparoscopy. After surgery,the observation group was given sunitinib malate capsules,50 mg each time,once a day,for 4 weeks of continuous medication and 2 weeks of withdrawal as 1 cycle;they received continuous treatment of 3 cycles and were followed for 24 months. Results After treatment,the levels of cancer antigen 19-9( CA19-9),carcinoembryonic antigen( CEA),cancer antigen 125( CA125) and vascular endothelial growth factor( VEGF),platelet-derived growth factor( PDGF),colony stimulating factor type 1( CSF-1) in the observation group were significantly lower than those of the control group( P < 0. 05);during the treatment period,the incidence of adverse reactions in the observation group and the control group was equivalent( 17. 78% vs. 11. 11%,P > 0. 05);during the follow-up,the recurrence rate,remote metastasis rate,reoperation rate and mortality rate of the observation group were significantly lower than those of the control group( P < 0. 05). Conclusion Sunitinib combined with laparoscopy for small gastrointestinal stromal tumor can decrease the level of tumor markers and pro-angiogenic factor,reduce the recurrence rate of patients with good long-term efficacy.