Goh B K P, Chow P K H, Chuah K L, Yap W M, Wong W K
Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
Eur J Surg Oncol. 2006 Nov;32(9):961-3. doi: 10.1016/j.ejso.2006.06.004. Epub 2006 Jul 12.
The aim of this study is to review the radiologic, PET scan and pathologic response and the outcome of patients with advanced GIST treated with neoadjuvant IM followed by surgical resection.
We report a case and review 36 patients reported in MEDLINE with advanced GIST treated with neoadjuvant IM followed by surgical resection.
Thirty-seven patients with a median age of 56 years (range, 32-76 years) at presentation were treated with neoadjuvant IM. Radiologic response accurately predicted pathological response in 31/36 patients, whereas PET scan was accurate in predicting treatment response in only 6/23 patients.
This study demonstrates that the pathologic response of GIST to IM is usually incomplete and does not correlate with the complete response seen on PET scan. This finding suggests that surgical resection will continue to play a vital role in the treatment of patients with advanced disease responding to IM treatment.
本研究旨在回顾晚期胃肠道间质瘤（GIST）患者在接受新辅助伊马替尼（IM）治疗后行手术切除的放射学、PET扫描及病理反应情况以及患者的预后。
我们报告1例病例，并回顾MEDLINE中报道的36例接受新辅助IM治疗后行手术切除的晚期GIST患者。
37例患者在就诊时的中位年龄为56岁（范围32 - 76岁），接受了新辅助IM治疗。在36例患者中，31例的放射学反应准确预测了病理反应，而在23例患者中，PET扫描仅在6例中准确预测了治疗反应。
本研究表明，GIST对IM的病理反应通常不完全，且与PET扫描所见的完全反应不相关。这一发现提示，手术切除在对IM治疗有反应的晚期疾病患者的治疗中仍将发挥至关重要的作用。
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