1例巨大小肠间质瘤伴肝转移的MDT治疗

目的探讨多学科协作团队(MDT)在诊治胃肠间质瘤(GIST)伴肝转移中的作用及意义。方法对川北医学院附属医院2018年8月收治的1例巨大(直径>10 cm)小肠间质瘤伴肝转移患者展开MDT讨论治疗的经验进行总结。结果该例患者为一46岁女性,初次就诊时即确诊GIST伴肝转移,已失去手术机会,采用新辅助治疗后肿瘤缩小,后经2次MDT讨论后成功完成了原发灶及转移灶的R0切除,患者术后继续口服伊马替尼600 mg/d治疗,截至目前总生存期已达31个月,复查未见肿瘤复发征象,仍继续随访中。结论酪氨酸激酶抑制剂联合手术治疗是GIST伴肝转移患者最适合的治疗方式,能提高患者生存期。在临床工作中,可合理运用MDT诊疗方式并贯彻于GIST伴肝转移患者的整个治疗过程中,为其提供最佳的治疗选择。

Treatment of 1 patient with small intestine stromal tumor with liver metastasis by MDT model

Objective To investigate the diagnosis and treatment value of multi-disciplinary team(MDT)model in patient with gastrointestinal stromal tumor(GIST)with liver metastasis.Method The experiences of MDT model in treating huge(>10 cm)GIST with liver metastasis in the Affiliated Hospital of North Sichuan Medical College on August 2018 were summarized.Results The 46 years old female patient diagnosed with intestinal stromal tumor with liver metastasis at the initial visit.There was no chance of surgery.After the neoadjuvant therapy,the tumor was shrunk.After 2 MDT discussions,the R0 resection of the primary tumor or metastases was successfully performed.And then the patient continued to receive the oral imatinib 600 mg/d.The current overall survival was 31 months till now.No recurrence of the tumor was observed and the follow-up was still continued.Conclusions Tyrosine kinase inhibitors combined metastasectomy may be the most appropriate treatment for patient diagnosed with GIST with liver metastasis,which can improve the survival.In clinical work,MDT model could be used reasonably and carried out during the whole treatment process to provide the best treatment option for patient with GIST with liver metastasis.