Gastrointestinal stromal tumors (GISTs) are rare tumors, which represent approximately 1% of the neoplasms of the gastrointestinal tract. These tumors rarely give extra-abdominal metastases. However, their clinical ou...Gastrointestinal stromal tumors (GISTs) are rare tumors, which represent approximately 1% of the neoplasms of the gastrointestinal tract. These tumors rarely give extra-abdominal metastases. However, their clinical outcome is potentially adverse. In some rare cases, co- existance of GISTs with other malignancies has been reported. Here we present a case of a 74-year old male with GIST, which was managed by surgical resection. Fourteen months later, the patient presented with liver metastases and imatinib mesylated was administered. During treatment, the patient reported skeletal pain and plane X-rays revealed osteolytic bone lesions. Further investigation revealed the presence of multiple myeloma. To the best of our knowledge, this is the first report of the co-existence of multiple myeloma (MM) with GIST.展开更多
Surgical treatments including radical resection and local excision remain the main treatment for primary rectal gastrointestinal stromal tumors(GISTs). However,since patients with high-grade rectal GISTs have a higher...Surgical treatments including radical resection and local excision remain the main treatment for primary rectal gastrointestinal stromal tumors(GISTs). However,since patients with high-grade rectal GISTs have a higher risk of tumor recurrence and a shorter life expectancy,neoadjuvant treatment is necessary. In this case report,the efficacy of imatinib mesylate (IM)as a neoadjuvant therapy was assessed in an old man with malignant rectal GIST.The patient received IM preoperative treatment for a short period of one and a half months;at the end of the IM treatment, computed tomography scanning showed a markedly reduced tumor size and cystic changes of the tissue. At that time,a function sphincter-sparing surgery was performed.The histological examination of the resected specimen detected no tumor cells,but residual blood vessels and scattered inflammatory lymphocytes.After surgery,the patient has been followed up without additional IM treatment and remained disease-free for 57 mo.This case indicates that IM neoadjuvant therapy can dramatically improve the prognosis of rectal malignant GIST.展开更多
The multidisciplinary approach is beneficial to the treatment of gastrointestinal stromal tumors(GISTs).However,pharmacists are seldom incorporated into a multidisciplinary team(MDT)of GIST.In the present study,we eva...The multidisciplinary approach is beneficial to the treatment of gastrointestinal stromal tumors(GISTs).However,pharmacists are seldom incorporated into a multidisciplinary team(MDT)of GIST.In the present study,we evaluated the clinical and economic benefits of a pharmacist in an MDT of GIST.This was a retrospective study that included 240 GIST patients receiving imatinib therapy.The GIST MDT pharmacist developed and validated an HPLC method to monitor the trough concentrations of imatinib in GIST patients.Besides,the pharmacist also provided patient education and pharmaceutical care services and collected the data for analysis.The 240 GIST patients received the services provided by the pharmacist.The trough concentrations in 25.42%of the 240 patients were less than 1100 ng/m L.The main genotypes of 121 in the 240 patients were KIT exon 11 mutations,wild type,and KIT exon 9 mutations.Moreover,13 GIST patients with trough concentrations less than 1100 ng/m L were confirmed to have low compliance.The adverse reactions were primarily mild and tolerable,except that 13 GIST patients were adjusted to lower doses because of the intolerable adverse reactions.The daily cost could be lowered by monitoring the trough concentrations and dose reductions.Collectively,a pharmacist included in a GIST MDT could increase the compliance of Chinese GIST patients to imatinib therapy and improve the efficacy,safety,and economy of imatinib therapy.展开更多
文摘Gastrointestinal stromal tumors (GISTs) are rare tumors, which represent approximately 1% of the neoplasms of the gastrointestinal tract. These tumors rarely give extra-abdominal metastases. However, their clinical outcome is potentially adverse. In some rare cases, co- existance of GISTs with other malignancies has been reported. Here we present a case of a 74-year old male with GIST, which was managed by surgical resection. Fourteen months later, the patient presented with liver metastases and imatinib mesylated was administered. During treatment, the patient reported skeletal pain and plane X-rays revealed osteolytic bone lesions. Further investigation revealed the presence of multiple myeloma. To the best of our knowledge, this is the first report of the co-existence of multiple myeloma (MM) with GIST.
基金The National Natural Science Foundation of China,No.30300152the Shanghai Science Technique Planning Foundation,No.064119622
文摘Surgical treatments including radical resection and local excision remain the main treatment for primary rectal gastrointestinal stromal tumors(GISTs). However,since patients with high-grade rectal GISTs have a higher risk of tumor recurrence and a shorter life expectancy,neoadjuvant treatment is necessary. In this case report,the efficacy of imatinib mesylate (IM)as a neoadjuvant therapy was assessed in an old man with malignant rectal GIST.The patient received IM preoperative treatment for a short period of one and a half months;at the end of the IM treatment, computed tomography scanning showed a markedly reduced tumor size and cystic changes of the tissue. At that time,a function sphincter-sparing surgery was performed.The histological examination of the resected specimen detected no tumor cells,but residual blood vessels and scattered inflammatory lymphocytes.After surgery,the patient has been followed up without additional IM treatment and remained disease-free for 57 mo.This case indicates that IM neoadjuvant therapy can dramatically improve the prognosis of rectal malignant GIST.
基金Chongqing Science and Technology Bureau and Chongqing Health Commission(Grant No.2021-MSXM335 and 2020GDRC009)。
文摘The multidisciplinary approach is beneficial to the treatment of gastrointestinal stromal tumors(GISTs).However,pharmacists are seldom incorporated into a multidisciplinary team(MDT)of GIST.In the present study,we evaluated the clinical and economic benefits of a pharmacist in an MDT of GIST.This was a retrospective study that included 240 GIST patients receiving imatinib therapy.The GIST MDT pharmacist developed and validated an HPLC method to monitor the trough concentrations of imatinib in GIST patients.Besides,the pharmacist also provided patient education and pharmaceutical care services and collected the data for analysis.The 240 GIST patients received the services provided by the pharmacist.The trough concentrations in 25.42%of the 240 patients were less than 1100 ng/m L.The main genotypes of 121 in the 240 patients were KIT exon 11 mutations,wild type,and KIT exon 9 mutations.Moreover,13 GIST patients with trough concentrations less than 1100 ng/m L were confirmed to have low compliance.The adverse reactions were primarily mild and tolerable,except that 13 GIST patients were adjusted to lower doses because of the intolerable adverse reactions.The daily cost could be lowered by monitoring the trough concentrations and dose reductions.Collectively,a pharmacist included in a GIST MDT could increase the compliance of Chinese GIST patients to imatinib therapy and improve the efficacy,safety,and economy of imatinib therapy.
