目的 探讨甲磺酸伊马替尼治疗胃肠道间质瘤(GIST)的疗效和毒副反应.方法 回顾性分析2007年1月~2011年1月北京大学肿瘤医院收治的56例GIST患者,均给予400 mg/d甲磺酸伊马替尼治疗,并观察治疗的近期效果、生存分析[生存期(OS)、无进展生存期(PFS)及1、3年的生存率]和毒副反应.结果 56例均可评价治疗效果,其中获完全缓解(CR)者6例(10.71%),部分缓解(PR)者35例(62.50%),稳定(SD)者8例(14.29%),有效率(RR)为73.21%,疾病控制率(DCR)为87.50%;截至随访结束,PFS及OS均未达到,且1、3年的生存率分别为91.4%和84.5%;全组毒副反应多为Ⅰ~Ⅱ级,且其中发生率≥10%的从高至低依次为白细胞下降(94.64%)、食欲减退(92.86%)、皮肤黏膜水肿(89.29%)、乏力(87.50%)、腹泻(76.79%)、恶心呕吐(66.07%)、肌肉酸痛(57.14%)、皮疹(35.71%)、血小板下降(26.79%)、肝功能损害(21.43%)和血红蛋白下降(16.07%);此外毒副反应Ⅲ级共有11例,未有Ⅳ级报道.结论 甲磺酸伊马替尼治疗GIST有效,安全性较好,但对于少数出现Ⅲ级毒副反应患者应及时对症治疗.%Objective To investigate the curative effect and toxicity reaction of Imatinib Mesylate in the treatment of gastrointestinal stromal tumor (GIST). Methods 56 patients with GIST in cancer hospital of Peking University from January 2007 to January 2011 were analyzed retrospectively, all patients were treated with Imatinib Mesylate in 400 mg/d. Recent curative effect, survival analysis [overall survival (OS), progression-free survival (MPFS) and survival rate of 1, 3 year] and toxicity reaction were analyzed. Results Curative effect of all 56 patients could be evaluated, 8 cases (14.29%) were complete remission (CR), 35 cases (62.50%) were partial remission (PR), 8 cases (14.29%) were stable disease (SD), the RR was 73.21%, disease control rate was 87.50%. At the end of the follow-up visit, OS and PFS were all not reached, the survival rate of 1, 3 year were 91.4% and 84.5%. The grades of toxicity reaction were mostly Ⅰ-Ⅱ, the toxicity reaction (occurrence rate ≥ 10%) arranged from high to low were decrease of leucocyte (94.64%), anorexia (92.86%), edema of skin and mucosa (89.29%), weakness (84.50%), diarrhea (76.79%), nausea/vomit (66.07%), muscular soreness (57.14%), rash (35.71%), decrease of soterocyte (26.79%), liver function impairment (21.43%), decrease of haemoglobin (16.07%). 11 cases had Ⅲ grade of toxicity reaction, Ⅳ grade toxicity reaction was not found. Conclusion Imatinib Mesylate has a positive curative effect and good safety for GIST treatment, but it is necessary to treat the toxicity reaction of Ⅲ grade, although it is minority.
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