伊马替尼治疗晚期及高危胃肠道间质瘤的临床疗效与安全性分析

发布时间：2018-05-12 03:11

本文选题：胃肠道间质肿瘤 + 蛋白激酶抑制剂　；参考：《中国普通外科杂志》2017年04期

【摘要】：目的:评价伊马替尼治疗晚期、高危胃肠道间质瘤(GIST)的临床疗效及安全性。方法:回顾2011年1月—2016年6月期间收治的173例GIST患者资料,其中晚期患者73例,高危患者100例,分别比较两类患者中服用伊马替尼患者与未服药患者的预后情况。结果:73例晚期患者平均随访31(6~66)个月;Cox回归分析显示,其中服用伊马替尼患者总生存期(OS)明显长于未服用伊马替尼患者(1年OS:100.0%vs.78.6%,2年OS:93.1%vs.26.1%;HR=0.040,95%CI=0.011~0.152,P=0.000)。100例高危患者平均随访45(6~73)个月;亚组分析示,其中术后服用伊马替尼1年患者较未服药患者无复发生存期(RFS)明显延长(3年RFS:66.7%vs.38.5%;HR=0.341,95%CI=0.134~0.868,P=0.024),而服用伊马替尼2年患者较服用伊马替尼1年患者RFS也明显提高(1年RFS:100.0%vs.100.0%,2年RFS:100.0%vs.88.9%,3年RFS:91.7%vs.66.7%;HR=0.108,95%CI=0.015~0.778,P=0.027);5例术后服用3年伊马替尼患者3年RFS为100.0%。服用伊马替尼的主要不良反应为浮肿、白细胞下降、胃肠道反应等,以1~2级为主。结论:伊马替尼治疗晚期、高危GIST有较好的安全性,能有效提高患者生存率;高危患者术后建议至少服用3年伊马替尼,但是否延长服药年限仍需更多的临床研究证实。
[Abstract]:Objective: to evaluate the efficacy and safety of imatinib in the treatment of advanced high-risk gastrointestinal stromal tumors (GIST). Methods: the data of 173 patients with GIST from January 2011 to June 2016 were retrospectively reviewed, including 73 patients with advanced stage and 100 patients with high risk. The prognosis of two groups of patients who took imatinib and those who did not take it were compared. Results the Cox regression analysis showed that the overall survival time of 73 patients with advanced stage was significantly longer than that of those who did not (1 year OS: 100.0vs.78.6a, 2 years OS93.1vs.26.1cm HR0.0404095CI0.0110.152P0.0000.000.100 patients with high risk patients followed up for an average of 45673months). The postoperative survival time of patients taking imatinib for 1 year was significantly longer than that of patients who did not take Imatinib (3 years RFS: 66.7vs.38.5vs.38.5vs.38.5vs.38.5vs.38.5vs.38.5vs.38.5V). The number of patients taking imatinib was 0.134 and 0.868P0.0240.The RFS of patients who took imatinib for 2 years was significantly higher than that of patients taking imatinib for one year (RFS100.0vs.100.0vs.10.9 RF2 years), and three years later, RFScell was 91.7vs.66.7HR0.100.108HR0.108I was 0.0150.778P0.027277.There were 5 cases of RFS in the group of patients taking Imatinib (RFS100.0vs.100.0vs.88.9rand RFSmember 91.7vs.66.7HR0.1085). The RFS was 100.0 for 3 years after treatment with imatinib. The main adverse reactions of taking imatinib were edema, leukopenia, gastrointestinal reaction and so on. Conclusion: high risk GIST has good safety in the late stage of imatinib therapy and can effectively improve the survival rate of the patients. It is recommended that the high risk patients should take imatinib for at least 3 years after operation, but more clinical studies are needed to confirm whether to prolong the duration of treatment.
【作者单位】：贵州医科大学附属医院胃肠外科;四川大学华西临床医学院胃肠外科;
【分类号】：R735

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