Knowlton Christin A, Brady Luther W, Heintzelman Rebecca C
Department of Radiation Oncology;
Rare Tumors. 2011 Oct 21;3(4):e35. doi: 10.4081/rt.2011.e35. Epub 2011 Oct 24.
Gastrointestinal stromal tumors (GISTs) are uncommon mesenchymal tumors of the gastrointestinal tract. Up to one-third of GISTs are malignant with a high rate of metastasis. Surgical resection is the mainstay of care for patients with resectable disease. Imatinib mesylate, a selective tyrosine kinase inhibitor, is the current standard of care for GISTs that cannot be completely resected or in cases of metastatic GIST. Although often overlooked, radiation therapy is a viable option for select patients with GIST. We report the case of a patient with unresectable GIST who was treated with local radiotherapy and achieved long-term response. We also present a review of the literature regarding the use of radiotherapy in the treatment of GIST. GIST has been shown to be a radiosensitive tumor. Radiotherapy can offer long-term local control and should be considered in the adjuvant or palliative setting. The role of radiotherapy delivered concurrently with imatinib in the treatment of GIST may warrant further investigation.
胃肠道间质瘤(GISTs)是胃肠道罕见的间叶组织肿瘤。高达三分之一的GISTs是恶性的,转移率很高。手术切除是可切除疾病患者的主要治疗方法。甲磺酸伊马替尼,一种选择性酪氨酸激酶抑制剂,是无法完全切除的GISTs或转移性GISTs病例的当前标准治疗方法。尽管常被忽视,但放射治疗对于某些GIST患者是一种可行的选择。我们报告了一例不可切除的GIST患者,该患者接受了局部放射治疗并取得了长期缓解。我们还对关于放射治疗在GIST治疗中的应用的文献进行了综述。GIST已被证明是一种对放疗敏感的肿瘤。放射治疗可提供长期局部控制,应在辅助或姑息治疗中予以考虑。与伊马替尼同时进行放射治疗在GIST治疗中的作用可能值得进一步研究。