甲磺酸伊马替尼治疗手术无法切除的晚期胃肠间质瘤

摘要

Objective:To evaluate the response rate and survival benefit of imatinib mesylate for advanced gastrointestinal stromal tu-mors (GIST). Methods:Sixty-one patients with unresectable GIST were recruited and given imatinib mesylate with an initial oral dose of 400 mg/day and received regular follow-ups to evaluate the response rate, survival benefit, and adverse effects. Results:The re-sponse rate was 57.4%(35/61), and the disease control rate was 88.5%(54/61) one year after initial treatment. Analysis of the Logic regression model shows that gender, age, and multiple lesions in the abdominal and pelvic cavity are factors that affect response rate (P<0.05). The five-year cumulative survival rate is 53%. The status of multiple lesions in abdominal and pelvic cavity affected the surviv-al benefit of the cases (P<0.05). Although adverse effects frequently occur, most of them were mild except for two hemorrhagic cases. Conclusion:The clinical use of imatinib mesylate significantly increases the survival of patients with unresectable or metastatic GIST. The efficacy and safety of imatinib mesylate guarantees it as a treatment choice for advanced GIST.%目的：探讨甲磺酸伊马替尼用于治疗晚期胃肠间质瘤的疗效及生存获益。方法：收集2004年9月至2015年6月天津医科大学肿瘤医院收治的无法手术切除的61例晚期胃肠间质瘤患者的临床资料，接受初始剂量400 mg/d的口服甲磺酸伊马替尼治疗，定期随访，评价生存获益及药物不良反应。结果：61例患者开始接受治疗1年后，治疗有效率为57.4%（35/61），疾病控制率为88.5%（54/61），Logic二元回归分析显示性别、年龄和腹盆腔多发病灶是影响治疗有效率的因素（P<0.05）。本组患者5年累积生存率为53%，Cox回归模型分析提示腹盆腔的多发病灶是影响患者生存获益的重要因素（P<0.05）。除2例患者出现出血，其余患者不良反应轻微。结论：甲磺酸伊马替尼显著改善晚期胃肠间质瘤的生存获益，可作为无法手术切除的晚期胃肠间质瘤的首选治疗。