医学理论与实践
醫學理論與實踐
의학이론여실천
The Journal of Medical Theory and Practice
2014年
16期
2114-2116
,共3页
章斐然%谢澳斯%陈君填%李威
章斐然%謝澳斯%陳君填%李威
장비연%사오사%진군전%리위
肠道间质肿瘤%肿瘤转移%肿瘤复发%伊马替尼
腸道間質腫瘤%腫瘤轉移%腫瘤複髮%伊馬替尼
장도간질종류%종류전이%종류복발%이마체니
Gastrointestinal stromal tumors%Neoplasm metastasis%Neoplasm recurrence%Imatinib%Targeted thera-py%Surgical Procedures
目的：探讨复发转移性胃肠道间质瘤（C IS T ）的治疗。方法：回顾分析我院2008-2012年5年间收治的30例复发转移性GIST患者的临床资料。结果：30例患者均予伊马替尼治疗后接受手术治疗。治疗有效（RD组）的18例中有13例、疾病进展（PD组）的12例中有1例共计14例（46．7％）患者肿瘤获得完全切除。RD组无疾病进展生存时间（PFS ）为24．9个月，PD组的 PFS 为2．7个月，两组比较，差异有统计学意义（ P＜0．01）。结论：在复发转移性GIST患者中，口服伊马替尼治疗有效的患者行二次手术切除是可行的；但是对于口服伊马替尼治疗无效的GIST 患者分为两类：局限性进展的GIST ，在评估手术可以完整切除局限进展肿瘤的情况下，仍建议实施手术治疗，术后可继续原剂量伊马替尼或增加剂量治疗，也可选择舒尼替尼治疗；广泛进展的GIST ，不建议采取手术，可以增加伊马替尼治疗，或改用舒尼替尼治疗。
目的：探討複髮轉移性胃腸道間質瘤（C IS T ）的治療。方法：迴顧分析我院2008-2012年5年間收治的30例複髮轉移性GIST患者的臨床資料。結果：30例患者均予伊馬替尼治療後接受手術治療。治療有效（RD組）的18例中有13例、疾病進展（PD組）的12例中有1例共計14例（46．7％）患者腫瘤穫得完全切除。RD組無疾病進展生存時間（PFS ）為24．9箇月，PD組的 PFS 為2．7箇月，兩組比較，差異有統計學意義（ P＜0．01）。結論：在複髮轉移性GIST患者中，口服伊馬替尼治療有效的患者行二次手術切除是可行的；但是對于口服伊馬替尼治療無效的GIST 患者分為兩類：跼限性進展的GIST ，在評估手術可以完整切除跼限進展腫瘤的情況下，仍建議實施手術治療，術後可繼續原劑量伊馬替尼或增加劑量治療，也可選擇舒尼替尼治療；廣汎進展的GIST ，不建議採取手術，可以增加伊馬替尼治療，或改用舒尼替尼治療。
목적：탐토복발전이성위장도간질류（C IS T ）적치료。방법：회고분석아원2008-2012년5년간수치적30례복발전이성GIST환자적림상자료。결과：30례환자균여이마체니치료후접수수술치료。치료유효（RD조）적18례중유13례、질병진전（PD조）적12례중유1례공계14례（46．7％）환자종류획득완전절제。RD조무질병진전생존시간（PFS ）위24．9개월，PD조적 PFS 위2．7개월，량조비교，차이유통계학의의（ P＜0．01）。결론：재복발전이성GIST환자중，구복이마체니치료유효적환자행이차수술절제시가행적；단시대우구복이마체니치료무효적GIST 환자분위량류：국한성진전적GIST ，재평고수술가이완정절제국한진전종류적정황하，잉건의실시수술치료，술후가계속원제량이마체니혹증가제량치료，야가선택서니체니치료；엄범진전적GIST ，불건의채취수술，가이증가이마체니치료，혹개용서니체니치료。
Objective :Analysis of recurrent metastatic gastrointestinal stromal tumors (CIST ) treatment .Methods :A retrospective analysis of our hospital in 2008-2012 5 years were 30 cases of recurrence and metastasis in patients with clinical data of GIST .Results:30 patients were treated with imatinib therapy to accept operation treatment .Complete re-sections were accomplished in 13 of the 18 responsive disease (RD) patients ,and in 1 of the 12 progression disease (PD) patients (46 .7% ) .The progression-free survival (PFS) time for patients with RD and PD were 24 .9 months and 2 .7 months ,respectively .The difference of PFS between patients with RD and those with PD were significant (P<0.01) .Conclusion:Surgical intervention following imatinib is feasible and can be considered for patients with advanced GIST responsive to imatinib .But for oral imatinib refractory GIST patients were divided into two categories :limita-tions in GIST ,in the assessment of operation can complete resection of locally advanced cancer cases ,still recommends the implementation operation treatment ,patients can keep the original dose of imatinib or increasing the dose of treat-ment ,can also choose to sunitinib treatment ;widely in GIST ,does not recommend taking operation ,can increase the treatment with imatinib ,sunitinib treatment or use .
