甲磺酸伊马替尼治疗胃肠道间质瘤后皮肤不良反应情况分析

发布时间：2018-08-22 14:03

【摘要】：目的了解甲磺酸伊马替尼治疗胃肠道间质瘤(GIST)后皮肤不良反应发生情况。方法选择2008年6月-2015年6月期间服用甲磺酸伊马替尼治疗的184例胃肠道间质瘤患者进行随访,包括患者的一般情况、间质瘤发病状况、治疗中的不良反应等。结果 184例患者中,发生皮肤不良反应66例(35.87%),其中严重皮肤不良反应6例(9.09%),6例患者中有4例予停止甲磺酸伊马替尼治疗,改为苏尼替尼治疗后皮损好转,但最终有2例因肝脏、腹腔转移分别于24个月、29个月后死亡,2例因复发胃、直肠间质瘤于18个月、26个月后死亡;另2例暂停甲磺酸伊马替尼7~10d后减量继续原法治疗,并加用糖皮质激素后皮损好转,继续用甲磺酸伊马替尼治疗中。结论甲磺酸伊马替尼治疗胃肠道间质瘤所发生的皮肤不良反应大多属于免疫介导的药物反应,轻中型病例无须特殊处理,重型病例可采用短暂停药、减量服药并加用糖皮质激素的方法进行治疗,采用苏尼替尼替代治疗对胃肠道间质瘤的疗效不佳。
[Abstract]:Objective to investigate the occurrence of adverse skin reactions after imatinib mesylate in the treatment of gastrointestinal stromal tumors (GIST) with (GIST). Methods 184 patients with gastrointestinal stromal tumors who were treated with imatinib mesylate from June 2008 to June 2015 were followed up, including the general condition of the patients, the incidence of stromal tumors and the adverse reactions in the treatment. Results of the 184 patients, 66 (35.87%) had adverse skin reactions, of which 6 (9.09%) were severe skin adverse reactions. 4 of the 6 patients were treated with imatinib mesylate and changed to sunitinib, but 2 cases were due to liver. Intraperitoneal metastasis occurred in 24 months, 2 cases died of recurrent stomach after 29 months, rectal stromal tumors died in 18 months and 26 months later, the other 2 cases were suspended imatinib mesylate for 10 days and continued to be treated with the original method, and the skin lesions were improved after adding glucocorticoid. Continue to be treated with imatinib mesylate. Conclusion the skin adverse reactions of imatinib mesylate in the treatment of gastrointestinal stromal tumors are mostly immune-mediated drug reactions, which do not require special treatment in light and medium-sized cases, and may be stopped temporarily in severe cases. Dosage reduction and glucocorticoid were used to treat gastrointestinal stromal tumors (GIST), and suanil replacement therapy was used to treat gastrointestinal stromal tumors (GIST).
【作者单位】：宁波市第四医院(象山县第一人民医院);宁波市李惠利医院;
【分类号】：R735;R758.25

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