CAJ | 학술논문

目的：探讨甲磺酸伊马替尼新辅助治疗原发直肠胃肠间质瘤（ GIST）的疗效及安全性。方法40例直肠GIST患者口服甲磺酸伊马替尼片400mg/天，连续口服6个月后评估手术指征。根据肿瘤大小和位置分别采用局部切除术、直肠低位前切除术和腹会阴联合直肠癌根治术。结果按RECIST 1．1版标准评价，获CR 3例，PR 31例，SD 4例，PD 2例；有效率（ RR）为85．0％，疾病控制率（ DCR）为95．0％；按Choi标准评价，获CR 3例，PR 28例，SD 7例，PD 2例；RR为77．5％， DCR为95．0％。治疗后获R0切除38例。40例患者的1年生存率为100．0％，2年生存率为95．0％。不良反应以轻度水肿发生率最高，为72．5％，其次为白细胞减少（47．5％）；其他不良反应包括乏力、腹痛、胃肠道反应等，均可耐受。结论直肠GIST患者术前使用甲磺酸伊马替尼辅助治疗，能够扩大患者的手术指征，提高R0切除率，疗效确切，安全性高，可以作为直肠GIST个体化治疗方案之一。
목적：탐토갑광산이마체니신보조치료원발직장위장간질류（ GIST）적료효급안전성。방법40례직장GIST환자구복갑광산이마체니편400mg/천，련속구복6개월후평고수술지정。근거종류대소화위치분별채용국부절제술、직장저위전절제술화복회음연합직장암근치술。결과안RECIST 1．1판표준평개，획CR 3례，PR 31례，SD 4례，PD 2례；유효솔（ RR）위85．0％，질병공제솔（ DCR）위95．0％；안Choi표준평개，획CR 3례，PR 28례，SD 7례，PD 2례；RR위77．5％， DCR위95．0％。치료후획R0절제38례。40례환자적1년생존솔위100．0％，2년생존솔위95．0％。불량반응이경도수종발생솔최고，위72．5％，기차위백세포감소（47．5％）；기타불량반응포괄핍력、복통、위장도반응등，균가내수。결론직장GIST환자술전사용갑광산이마체니보조치료，능구확대환자적수술지정，제고R0절제솔，료효학절，안전성고，가이작위직장GIST개체화치료방안지일。
Objective To explore the efficacy and safety of imatinib mesylate as neoadjuvant treatment for rectal stromal tumors patients. Methods Forty cases of rectal stromal tumor patients were given imatinib mesylate tablets orally,400mg/d lasting for 6 months,and then the operation indication was assessed. According to the size and location of the tumor, patients were underwent local excision, rectal low anterior resection or abdominoperineal resection combined with rectal cancer treatment. Results By RECIST 1. 1 criterion, 3 cases got CR, 31 cases had PR, 4 cases got SD and 2 cases were of PD. The response rate(RR) was 85. 0%, and the dis-ease control( DCR) rate was 95. 0%. By Choi criterion, 3 cases got CR, 28 cases had PR, 7 cases got SD and 2 cases were of PD. RR was 77. 5%, and DCR was 95. 0%. R0 resection was performed in 38 cases. The 1-year survival rate was 100. 0%, and 2-year survival rate was 95. 0%. The incidence rate of mild edema was the highest ( 72. 5%) , followed by leukopenia ( 47. 5%) , and the other ad-verse effects included fatigue, abdominal pain and gastrointestinal reaction, which were tolerable. Conclusion Preoperative use of imatinib mesilate in rectal stromal tumors can expand the indications of operation,as well as raise R0 resection rate with stable efficacy and safety, and this neoadjuvant treatment can be used as individual treatment of rectal stromal tumors.