Surgical Resection Combined with Systemic Imatinib Therapy for the Treatment of Advanced Gastrointestinal Stromal Tumor

侵犯性腸胃道基質瘤的手術切除合併IMATINIB 治療

黃其民(Chi-Cheng Huang) ； 連恆煇(Heng-Hui Lien) ； 黃清水(Ching-Shui Huang) ； 宋詠娟(Yuan-Chuan Sung)

《Formosan Journal of Surgery》 37卷5期 (2004/10) Pp. 218-224

https://doi.org/10.29833/FJS.200410.0004

摘要

侵犯性腸胃道基質瘤的外科手術治療，常因低切除率和高復發率而效果不彰，使用imatinib的分子標靶治療，可有效改善此一情況。針對手術無法切除的侵犯性腸胃道基質瘤，imatinib輔助治療可造成腫瘤體積縮減，提高手術成功的機會。對於侵犯性腸胃道基質瘤手術後復發，imatinib輔助治療也可延緩腫瘤的生長並增加再次手術切除的機會。
我們報告兩例侵犯性腸胃道基質瘤外科手術切除合併imaiinib治療。第一例是手術無法切除的侵犯性腸胃道基質瘤合併腹膜轉移，在使用十個月imatinib治療後，腫瘤大幅縮小並可以成功地施行外科手術切除。第二例是侵犯性腸胃道基質瘤手術切除七個月後再度復發，在持續使用imatinib治療後腫瘤生長情形獲得控制。Imatinib使用的時機、時間長短及劑量仍未有共識，並仍需進一步的追蹤研究。此外，對於侵犯性腸胃道基質瘤患者，持續的追蹤也是必要的。

並列摘要

The results of surgical treatment of advanced gastrointestinal stromal tumor (GIST) are poor due to low resectability and high recurrence. This situation has been improved by the use of novel targeted molecular therapy with imatinib. For unresectable advanced GIST, the neo-adjuvant role of imatinib relies on cytoreduction and tumor shrinkage. The operability is increased and further definite surgery is facilitated. In cases with postoperative relapse, adjuvant imatinib therapy still provides the benefits of postponing tumor progression and enabling subsequent surgeries. We report two cases of advanced GISTs treated with surgery and imatinib. The first case was an inoperable advanced GIST with peritoneal sarcomatosis which became resectable after systemic imatinib therapy for 10 months. The second case had recurrent GIST after en bloc resection seven months earlier and resulted in stable disease status with continuous imatinib therapy. The timing, duration and dosage of imatinib remain inconclusive and demand further studies. Lifelong follow-up of advanced GISTs is mandatory.

並列關鍵字

gastrointestinal stromal tumor ； imatinib ； surgery