晚期胃肠道间质瘤靶向治疗后的外科治疗

目的探讨手术对于伊马替尼治疗后晚期胃肠道间质瘤（GIST）患者的临床疗效。方法回顾性分析13例术前予以伊马替尼治疗，然后接受手术切除的晚期GIST患者的临床资料。结果13例伊马替尼治疗后手术切除的患者中，有3例为局部晚期原发肿瘤，10例为复发或转移患者。治疗有效（RD组）的5例中有4例、疾病进展（PD组）的8例中有1例共计5例（38．5％）患者肿瘤获得完全切除。RD组无疾病进展生存（PFS）为24．8个月，PD组的PFS为2．8个月，两组比较，差异有统计学意义（P〈0．01）。RD组和PD组患者的总生存率比较，差异无统计学意义（P〉0．05）。结论在对伊马替尼治疗有效的晚期GIST患者中，伊马替尼治疗后再行外科手术切除是可行的。

Surgical treatment for patients with advanced gastrointestinal stromal tumor after targeted therapy

Objective To explore the role of surgery and its long-term outcome in patients with advanced gastrointestinal stromal tumor(GIST) treated with imatinib preoperatively. Methods Thirteen patients receiving imatinib therapy preoperatively, were retrospectively assessed for completeness of surgical resection and for disease-free and overall survival after resection. Results Thirteen patients, including 3 patients with locally advanced primary GIST and 10 patients with recurrent or metastatic GIST, underwent surgery after preoperative treatment with imatinib. Complete resections were accomplished in 4 of the 5 responsive disease(RD) patients, and in 1 of the 8 progression disease(PD) patients (38.5%). The progression-free survival (PFS) time for patients with RD and PD were 24.8 months and 2.8 months respectively. The difference of PFS between patients with RD and those with PD was significant (P<0.01). Median overall survival (OS) was not reached in both patients with RD and PD. The difference of OS between patients with RD and those with PD was not significant (P>0.05). Conclusion Surgical intervention following imatinib is feasible and can be considered for patients with advanced GIST responsive to imatinib.