摘要
目的 评价甲磺酸伊马替尼进行术前辅助治疗及治疗术后复发和 (或 )转移性胃肠间质瘤 (GISTs)的临床疗效及不良反应。方法 经病理组织学证实的GISTs 30例 ,其中 2 9例CD117阳性。行术前辅助化疗 2例 ,术后复发或已转移并失去手术机会者 2 8例 ,给予甲磺酸伊马替尼 2 0 0～ 6 0 0mg/d口服。结果 30例患者中 ,3例失访 ,2 5例可评价客观疗效。部分缓解 (PR) 15例 ,占 6 0 .0 % ;病情稳定 (SD) 5例 ,占 2 0 .0 % ;疾病进展 (PD) 5例 ,占 2 0 .0 %。患者获益 (CR +PR +SD)率 80 .0 % ,获益者中位无进展生存期 (TTP)超过 13个月。随访 1年以上者 2 2例 ,1年生存率为 86 .4 %。 2 7例可评价不良反应 ,其中轻度水肿 2 3例 (85 .2 % ) ,Ⅰ、Ⅱ度白细胞减少 11例 (40 .7% ) ,Ⅰ、Ⅱ度乏力 8例(2 9.6 % ) ,轻度腹痛 4例 (14 .8% ) ,Ⅰ、Ⅱ度恶心呕吐 5例 (18.5 % ) ,轻度皮疹 3例 (11.1% ) ,出血 2例(7.4 % )。结论 甲磺酸伊马替尼治疗进展期GISTs疗效肯定 ,不良反应较轻 ,患者能够耐受 ,可以较长时期用于转移性和 (或 )不能手术的GISTs治疗。
Objective To eveluate the efficacy and safety of imatinib mesylate in the treatment of patients as preoperative supplement, or used alone for unresectable and(or) metastatic gastrointestinal stromal tumor(GIST). Methods A total of 30 cases with advanced GIST were proved pathologically. Among them, CD117 was detected positive in 29 patients; 2 patients received imatinib mesylate before operation and 28 patients with unresectable and(or) metastatic GIST received oral imatinib mesylate daily at dose of 200-600 mg. Three patients were lost in follow-up and the objective effect was evaluated in 25 patients. Results Fifteen of 25 patients (60.0%) achieved partial response (PR); 5 (20.0%) had stable disease (SD) and 5 (20.0%) had progression disease (PD). Median time to progression (mTTP) was more than 13 months during which most experienced benefit. Twenty-two patients had been followed-up more then 1 year. The 1-year survival rate was 86.4%. The overall median survival has not been obtained to date. Twenty-seven patients were valuable for the toxicity assessment according to the WHO standard. The main toxicity included grade Ⅰ-Ⅱ edema of periorbital area and lower limb in 85.2% (23/27) patients, leukopenia was present in 40.7% (11/27) and intratumoral bleeding in 7.4% (2/27). Other toxicities included mild fatigue(29.6%), abdominal pain(14.8%), efflorescence (11.1%), nausea and vomiting(18.5%). Conclusion As an inhibitor of tyrosine kinase, imatinib mesylate is generally well tolerated and has been proved to be effective and safe during prolonged treatment of patients with advanced gastrointestinal stromal tumors.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2004年第11期697-699,共3页
Chinese Journal of Oncology
关键词
甲磺酸伊马替尼
治疗
复发性胃肠间质瘤
转移性胃肠间质瘤
Gastrointestinal neoplasms/drug therapy
Stromal tumors/drug therapy
CD117
Imatinib mesylate/therapeutic use
