【摘要】：目的了解甲磺酸伊馬替尼治療胃腸道間質(zhì)瘤(GIST)后皮膚不良反應(yīng)發(fā)生情況。方法選擇2008年6月-2015年6月期間服用甲磺酸伊馬替尼治療的184例胃腸道間質(zhì)瘤患者進行隨訪,包括患者的一般情況、間質(zhì)瘤發(fā)病狀況、治療中的不良反應(yīng)等。結(jié)果 184例患者中,發(fā)生皮膚不良反應(yīng)66例(35.87%),其中嚴(yán)重皮膚不良反應(yīng)6例(9.09%),6例患者中有4例予停止甲磺酸伊馬替尼治療,改為蘇尼替尼治療后皮損好轉(zhuǎn),但最終有2例因肝臟、腹腔轉(zhuǎn)移分別于24個月、29個月后死亡,2例因復(fù)發(fā)胃、直腸間質(zhì)瘤于18個月、26個月后死亡;另2例暫停甲磺酸伊馬替尼7~10d后減量繼續(xù)原法治療,并加用糖皮質(zhì)激素后皮損好轉(zhuǎn),繼續(xù)用甲磺酸伊馬替尼治療中。結(jié)論甲磺酸伊馬替尼治療胃腸道間質(zhì)瘤所發(fā)生的皮膚不良反應(yīng)大多屬于免疫介導(dǎo)的藥物反應(yīng),輕中型病例無須特殊處理,重型病例可采用短暫停藥、減量服藥并加用糖皮質(zhì)激素的方法進行治療,采用蘇尼替尼替代治療對胃腸道間質(zhì)瘤的療效不佳。
[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).
【作者單位】： 寧波市第四醫(yī)院(象山縣第一人民醫(yī)院);寧波市李惠利醫(yī)院;
【分類號】：R735;R758.25

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本文編號：2197319