Sakamoto Yasuo, Akimoto Hisafumi, Kojo Miyako, Kawano Hiroyuki, Chinen Yoshiki, Morita Kazutoyo, Sugiyama Masahiko, Saeki Hiroshi, Minami Kazuhito, Soejima Yuji, Sakaguchi Yoshihisa, Toh Yasushi, Okamura Takeshi
Dept. of Gastroenterological Surgery, National Kyushu Cancer Center.
Gan To Kagaku Ryoho. 2011 May;38(5):827-30.
We report a case of imatinib-resistant GIST, successfully treated by sunitinib. A 62-year-old man with high-grade fever and a huge abdominal tumor was diagnosed with malignant GIST and multiple liver metastases. We performed total gastrectomy combined with distal pancreatectomy, and splenectomy for palliation. Imatinib at a dose of 300mg/day was administered postoperatively, and the liver metastases was well controlled. After nine months, abdominal dissemination increased, and we raised the dose of imatinib to 400mg/day for the progressive state. Subsequently, we had to discontinue imatinib due to its adverse effects. Because the tumors progressed greatly while imatinib was discontinued, we changed to sunitinib. After wards, tumors reduced and his general condition improved remarkably. Although tumors progressed after five months, he was able to obtain good QOL during the administration of sunitinib. Sunitinib is useful for imatinib-resistant GIST, and may be a promising treatment even for patients with poor PS.
我们报告了一例伊马替尼耐药的胃肠道间质瘤(GIST)患者,经舒尼替尼成功治疗。一名62岁男性,伴有高热和巨大腹部肿瘤,被诊断为恶性GIST并伴有多发肝转移。我们进行了全胃切除术联合远端胰腺切除术及脾切除术以缓解症状。术后给予300mg/天的伊马替尼,肝转移得到良好控制。九个月后,腹部播散增加,针对病情进展我们将伊马替尼剂量提高至400mg/天。随后,由于伊马替尼的不良反应我们不得不停药。在停用伊马替尼期间肿瘤进展显著,因此我们换用舒尼替尼。此后,肿瘤缩小,他的一般状况明显改善。尽管五个月后肿瘤进展,但在使用舒尼替尼期间他能够获得良好的生活质量。舒尼替尼对伊马替尼耐药的GIST有效,对于身体状况较差的患者可能也是一种有前景的治疗方法。