CAJ | 학술논문

目的胃肠间质瘤( Gastrointestinal stromal tumor,GIST)是胃肠道最常见的间叶来源性肿瘤,根治性手术是GIST获得治愈的唯一希望. 为了提高手术根治性切除率,降低手术风险,提高生活质量,伊马替尼( IM)开始被尝试应用于GIST的术前治疗. 方法本研究回顾8例GIST术前辅助治疗后手术的诊疗经过. IM每日一次400 mg口服,严密随访,评价疗效,并通过多学科讨论确定手术时机. 用药时间12周~40周. 对IM术前辅助治疗的临床疗效和安全性予以评价. 结果术前治疗部分缓解率62.5%.本组病例未出现不可耐受的不良反应. 全部病例均获R0 切除,未出现术中肿瘤破裂. 术后恢复顺利. 结论针对进展期胃部巨大GIST及近贲门区GIST,在多学科诊疗团队的监护下,术前辅助IM治疗安全有效,值得临床推广应用.
목적 위장간질류( Gastrointestinal stromal tumor,GIST)시위장도최상견적간협래원성종류,근치성수술시GIST획득치유적유일희망. 위료제고수술근치성절제솔,강저수술풍험,제고생활질량,이마체니( IM)개시피상시응용우GIST적술전치료. 방법 본연구회고8례GIST술전보조치료후수술적진료경과. IM매일일차400 mg구복,엄밀수방,평개료효,병통과다학과토론학정수술시궤. 용약시간12주~40주. 대IM술전보조치료적림상료효화안전성여이평개. 결과 술전치료부분완해솔62.5%.본조병례미출현불가내수적불량반응. 전부병례균획R0 절제,미출현술중종류파렬. 술후회복순리. 결론 침대진전기위부거대GIST급근분문구GIST,재다학과진료단대적감호하,술전보조IM치료안전유효,치득림상추엄응용.
Objective Gastrointestinal stromal tumor( GIST) is a rare mesenchymal tumor from gastroin-testinal tract,and surgery remains the only curative treatment.In order to improve the outcome of surgical treat-ment,reduce the risk of surgery,and increase the quality of life,preoperative imatinib( IM) treatment for GIST is investigated.Methods We retrospectively studied the multidisciplinary team model treatments for 8 GIST cases receiving preoperative IM treatment.The cases were prescribed IM of 400 mg daily for 12 to 40 weeks and exten-sively followed until surgery was considered feasibleg.The clinical significance and safety profile were analyzed. Results Partial responsive rate was 62.5% in this study.There was no intolerable sever adverse effects by IM preoperative treatment.All the cases received R0 dissection,with no intraoperative tumor rupture.The postopera-tive recovery was satisfied.Conclusion IM preoperative treatment brings significant clinical benefit to large stomach GISTs and cardiac region GISTs.The preoperative treatment should be monitored carefully under a multi-disciplinary team.Preoperative IM treatment is an evocative treatment strategy for high risk GIST.