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胃肠道间质瘤(gastrointestinal stromal tumor,GIST)是最常见的胃肠道间质源性肿瘤,最常发生于胃,其次为小肠。然而,胃肠道间质瘤骨转移的病例极为少见。目前为止,中英文文献报道的GIST骨转移仅17例。本文通过对相关文献进行综述发现,17例患者出现骨转移的平均年龄约为61.59岁。大部分患者表现为骨的多发转移,涉及的部位主要有脊柱、肋骨、骨盆、肱骨、股骨等,脊柱仍是GIST骨转移最常见的部位。GIST骨转移患者的平均生存时间超过48.35个月,转移病灶经手术切除和非手术切除的预后时间分别为60.38个月和37.67个月;转移病灶采用手术切除联合使用靶向药物与其他治疗方式相比,平均预后时间分别为73.17个月和34.82个月。GIST出现骨转移时的年龄不同,患者的预后也不同:<60岁及>60岁者平均预后时间分别为62.11个月和32.88个月。本研究认为,手术切除应作为GIST骨转移首选的治疗方式,术后及早联合伊马替尼等进行靶向治疗,可提高患者的生活质量,延长生存期。
Gastrointestinal stromal tumor (GIST) is the most common gastrointestinal stromal tumor, most commonly occurring in the stomach, followed by the small intestine. However, cases of gastrointestinal stromal tumor bone metastases are extremely rare. So far, only 17 cases of GIST bone metastases have been reported in Chinese and English literature. In this paper, a review of the relevant literature found that 17 cases of patients with bone metastases average age of about 61.59 years old. Most patients showed multiple bone metastases, involving the main parts of the spine, ribs, pelvis, humerus, femur, spine remains the most common site of GIST bone metastases. The mean survival time of patients with GIST bone metastasis was over 48.35 months. The prognosis of the patients with GIST bone metastases was 60.38 months and 37.67 months respectively. The metastatic lesions were treated with surgical resection combined with other drugs The mean prognostic time was 73.17 months and 34.82 months respectively. The prognosis of patients with different GIST bone metastases is different: the average prognosis for patients <60 years and> 60 years is 62.11 months and 32.88 months, respectively. This study suggests that surgical resection should be the first choice of treatment for GIST bone metastases, and early combined with imatinib and other targeted therapy after surgery can improve the quality of life of patients and prolong survival.