Clinical efficacy of imatinib mesylate as neoadjuvant therapy combined with surgery in patients with advanced gastrointestinal stromal tumors (A report of 92 cases) / 解放军医学杂志

ABSTRACT

Objective To evaluate the clinical efficacy of imatinib mesylate as an adjuvant therapy in combination with surgery for advanced gastrointestinal stromal tumors. Methods A total of 92 patients with advanced gastrointestinal stromal tumors, which were confirmed by pathological examination, were enrolled in this study from Jan. 2007 to Jan. 2012. There were 57 male and 35 female patients with age range of 21-85 years, and disease courses from one month to 2.5 years. The lesion was located in the stomach in 41 patients, jejunum in 11, ileum in 9, colon in 17, and rectum in 14. All of them received imatinib mesylate at a dose of 400mg/d for 3-9 months. According to Choi's efficacy evaluation criteria, therapeutic efficacy and adverse reactions were recorded. Results All of the patients were followed up for 9-50 months. Two patients achieved complete response (CR), 45 partial response (PR), 31 stable disease (SD) and 14 had disease progression (PD). Six patients died. The overall response rate (ORR) was 51.1% and disease control rate(DCR) was 84.6%. The adverse reactions were mainly facial and lower extremity edema to varying degrees, neutropenia, nausea and vomiting. Fifty-four patients received surgery after adjuvant therapy, the resection rate was 58.7%. The overall survival rates at 1 and 3 years were 100% and 93.4% respectively. Conclusions Imatinib mesylate as adjuvant therapy has good therapeutic efficacy for middle-late gastrointestinal stromal tumor. It can prolong patient life and improve the resection rate. Only mild adverse reactions occur and its toxicity is acceptable.