Abstract:

Follow-up and subsequent treatment after standard therapy of gastrointestinal stromal tumor        LI Guo-li, HE Qi. Department of General Surgery, Nanjing General Hospital of Nanjing Military Command of PLA, Nanjing 210002, China
Corresponding author: LI Guo-li, E-mail: drguoli@aliyun.com
Abstract    Gastrointestinal stromal tumor (GIST) is considered to have malignant potential and has a high risk of recurrence and metastasis. GIST patients need a systematic follow-up after standard treatment. Imatinib is the first choice for metastatic and unresectable GIST. Targeted therapy before surgery is a main treatment，and the majority criteria for evaluating treatment is the tumor can or cannot be surgically removed after the treatment, which is not equal to the therapeutic evaluation. Following surgical resection of GIST, adjuvant treatment with imatinib ameliorates the outcomes. Higher dose of imatinib, regorafenib and pazopanib could be used for patients who fail the standard therapy.

Key words: gastrointestinal stromal tumor, follow-up, recurrence, metastasis

摘要：

胃肠间质瘤（GIST）具有潜在的恶性倾向，易转移、复发，规范化治疗后的GIST病人需要进行系统性的随访，尤其是复发风险度为中、高危者，手术或药物治疗效果不理想者。伊马替尼是治疗复发性GIST的首选药物，治疗过程中可切除者应争取手术切除，其关键的环节在于判断药物治疗后的GIST能否达到可切除标准，而可切除标准不等同于疗效的评价。术后伊马替尼辅助治疗可以进一步改善预后，对标准化治疗失败者，增加伊马替尼剂量或以舒尼替尼、瑞格非尼等药物继续治疗仍可取得疗效。

关键词: 胃肠间质瘤, 随访, 复发, 转移