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胃肠道间质瘤管理的评估及当前趋势:一项系统综述

Evaluation of and Current Trends in the Management of Gastrointestinal Stromal Tumors: A Systematic Review.

作者信息

Arzoun Hadia, Srinivasan Mirra, Adam Mona, Thomas Siji S, Kuta Amber, Sandoval Stephanie

机构信息

Internal Medicine, St. Bernards Medical Center, Jonesboro, USA.

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

出版信息

Cureus. 2022 Jul 14;14(7):e26848. doi: 10.7759/cureus.26848. eCollection 2022 Jul.

Abstract

Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can occur anywhere in the digestive tract, with the stomach and small intestine being the most common locations. Because no imaging modalities diagnose GIST unequivocally, histological and immunohistochemical confirmation is usually required. Most GISTs are discovered by chance; hence, determining this condition's actual frequency can be challenging. Since diagnosing the tumor could be difficult, including GIST in the differential diagnosis is crucial. The objective of this review is to explore the multiple treatment options for this tumor and provide clinicians with more information on the evolving treatment modalities, which in the future could be a possible solution to cure GIST ultimately. After exploring several studies, the authors conclude that early detection is critical since the treatment depends on the tumor size, mitotic rate, and location. Medical management using targeted therapy approved by the United States Food and Drug Administration (FDA) include tyrosine kinase inhibitors such as imatinib, sunitinib, and regorafenib. Surgical resection of the tumor is also done in cases with localized tumors. Standard chemotherapy and radiotherapy are not commonly used to treat GIST patients. However, radiotherapy may be used as a palliative therapy to ease pain (such as bone pain) or control bleeding. Additional research is needed to establish potential therapeutic targets that will result in higher and longer-term response rates.

摘要

胃肠道间质瘤(GISTs)是一种软组织肉瘤,可发生于消化道的任何部位,其中胃和小肠最为常见。由于没有任何影像学检查能够明确诊断GIST,通常需要进行组织学和免疫组化确诊。大多数GIST是偶然发现的;因此,确定这种疾病的实际发病率可能具有挑战性。由于诊断肿瘤可能困难,将GIST纳入鉴别诊断至关重要。本综述的目的是探讨该肿瘤的多种治疗选择,并为临床医生提供更多关于不断发展的治疗方式的信息,这些治疗方式未来可能是最终治愈GIST的一种可能解决方案。在对多项研究进行探讨后,作者得出结论,早期检测至关重要,因为治疗取决于肿瘤大小、有丝分裂率和位置。美国食品药品监督管理局(FDA)批准的使用靶向治疗的药物治疗包括酪氨酸激酶抑制剂,如伊马替尼、舒尼替尼和瑞戈非尼。对于局限性肿瘤患者,也会进行肿瘤的手术切除。标准的化疗和放疗通常不用于治疗GIST患者。然而,放疗可作为一种姑息治疗来缓解疼痛(如骨痛)或控制出血。需要进一步研究以确定潜在的治疗靶点,从而提高反应率并延长反应时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4312/9281617/6dcc9635e504/cureus-0014-00000026848-i01.jpg

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