Yoshida Yasushi, Akahoshi Shinichi, Kiyota Yoshitaka, Motooka Yamato, Kiyozumi Yuuki, Yamaguchi Risa, Inoue Katsuhiko
Dept. of Surgery, Kumamoto Rosai Hospital.
Gan To Kagaku Ryoho. 2013 Dec;40(13):2573-5.
The patient was an 82-year-old man who had undergone resection of a gastrointestinal stromal tumor(GIST)of the small intestine in January 2000, when he was 69 years old. As peritoneal recurrences were diagnosed in June 2002, we performed peritoneal tumorectomy twice, and the perirectal tumor was controlled with imatinib for over 7 years. Resistance to imatinib was diagnosed in March 2011, and treatment was switched to sunitinib. Administration of sunitinib was started at 50mg/day for 28 days followed by treatment withdrawal for 14 days; however, the dose needed to be reduced twice and then discontinued owing to the occurrence of side effects and pemphigoid. During discontinuation of sunitinib, the tumor increased in size and cancer pain appeared; therefore, sunitinib was re-administered at a very low-dose of 12.5mg every alternate day. Low dose sunitinib was effective; the perirectal tumor was reduced and cancer pain disappeared.
该患者为一名82岁男性,2000年1月69岁时接受了小肠胃肠道间质瘤(GIST)切除术。2002年6月诊断出腹膜复发,我们进行了两次腹膜肿瘤切除术,直肠周围肿瘤用伊马替尼控制了7年多。2011年3月诊断出对伊马替尼耐药,治疗改为舒尼替尼。舒尼替尼开始以50mg/天给药28天,然后停药14天;然而,由于出现副作用和类天疱疮,剂量需要两次减少,然后停药。在舒尼替尼停药期间,肿瘤增大且出现癌痛;因此,舒尼替尼以极低剂量12.5mg隔天重新给药。低剂量舒尼替尼有效;直肠周围肿瘤缩小,癌痛消失。