Uno Futoshi, Fujiwara Yasuhiro, Fujiwara Toshiyoshi
Dept. of Gastroenterological Surgery, Okayama University Graduate School of Medicine and Dentistry, Japan.
Gan To Kagaku Ryoho. 2013 Sep;40(9):1241-4.
The patient was a 70-year-old woman with gastrointestinal stromal tumor(GIST)of the small intestine, accompanied by liver metastasis. Multiple liver metastases were pointed out 3 months after R0 surgery(jejunectomy and hepatectomy). Although she was given radiofrequency ablation(RFA)therapy and imatinib, metastatic tumors progressed. In a further examination at our institution 21 months after R0 surgery, multiple liver, bone, and lung metastases were indicated, and she was given sunitinib once daily at a 50mg in 6-week courses, with 4 weeks on and 2 weeks off treatment. Although sunitinib dosage was decreased to 25mg/day because of adverse events, 21 courses of this treatment were administered, and it took 137 weeks to progress her disease with this sunitinib treatment. At our institution, seven cases of GIST were treated with sunitinib, and the median time to progression was 30-weeks. That was almost the same result as for Japan and international clinical trials. Sunitinb treatment may be one of the most important therapeutic options for unresectable imatinib-resistant GIST.
该患者为一名70岁女性,患有小肠胃肠道间质瘤(GIST)并伴有肝转移。在R0手术(空肠切除术和肝切除术)3个月后发现多处肝转移。尽管她接受了射频消融(RFA)治疗和伊马替尼治疗,但转移瘤仍进展。在R0手术21个月后于我院进一步检查时,发现多处肝、骨和肺转移,遂给予舒尼替尼,每日一次,每次50mg,每6周为一个疗程,治疗4周,休息2周。尽管因不良事件舒尼替尼剂量减至25mg/天,但仍给予了21个疗程的该治疗,使用舒尼替尼治疗使她的疾病进展耗时137周。在我院,7例GIST患者接受了舒尼替尼治疗,疾病进展的中位时间为30周。这与日本及国际临床试验的结果几乎相同。舒尼替尼治疗可能是不可切除的伊马替尼耐药GIST最重要的治疗选择之一。