本文選題：胃腸道間質(zhì)腫瘤 + 蛋白激酶抑制劑��； 參考：《中國普通外科雜志》2017年04期

【摘要】：目的:評價伊馬替尼治療晚期、高危胃腸道間質(zhì)瘤(GIST)的臨床療效及安全性。方法:回顧2011年1月—2016年6月期間收治的173例GIST患者資料,其中晚期患者73例,高�；颊�100例,分別比較兩類患者中服用伊馬替尼患者與未服藥患者的預(yù)后情況。結(jié)果:73例晚期患者平均隨訪31(6~66)個月;Cox回歸分析顯示,其中服用伊馬替尼患者總生存期(OS)明顯長于未服用伊馬替尼患者(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�；颊咂骄S訪45(6~73)個月;亞組分析示,其中術(shù)后服用伊馬替尼1年患者較未服藥患者無復(fù)發(fā)生存期(RFS)明顯延長(3年RFS:66.7%vs.38.5%;HR=0.341,95%CI=0.134~0.868,P=0.024),而服用伊馬替尼2年患者較服用伊馬替尼1年患者RFS也明顯提高(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例術(shù)后服用3年伊馬替尼患者3年RFS為100.0%。服用伊馬替尼的主要不良反應(yīng)為浮腫、白細胞下降、胃腸道反應(yīng)等,以1~2級為主。結(jié)論:伊馬替尼治療晚期、高危GIST有較好的安全性,能有效提高患者生存率;高�；颊咝g(shù)后建議至少服用3年伊馬替尼,但是否延長服藥年限仍需更多的臨床研究證實。
[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.
【作者單位】： 貴州醫(yī)科大學(xué)附屬醫(yī)院胃腸外科;四川大學(xué)華西臨床醫(yī)學(xué)院胃腸外科;
【分類號】：R735

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