Clinical Research Of Adjuvant Post-surgical Therapy With Imatinib In Gastrointestinal Stromal Tumor Patients

Objective:To investigate the clinicopathologic characteristics, diagnosis and treatment and to evaluate the efficacy and safety of postoperative adjuvant therapy with imatinib mesylate in gastrointestinal stromal tumor patients who had high risk of recurrence.Patients and methods:1. General condition of the patients:30 patients are confirmed to be gastrointestinal stromal tumor patients with high recurrence by pathology after operations from October 2006 to December 2009 in Shandong Provincial Hospital, including 19 males and 11 females, aged 28 to 75 years old, mean age is 56 years.2. Clinical treatment:30 gastrointestinal stromal tumor patients all underwent radical surgical resection. Pathology specimen sent for pathological and immunohistochemical examination. All patients are treated with imatinib mesylate after operations, the initial dose were 400mg/d, and taking time last from 1 to 24 months.Result:1. The pathological and immunohistochemical results of 30 gastrointestinal stromal tumor patients show that CD117 positive in 29 cases, the positive rate was 96.7%; CD34 positive rate was 66.7%(14/21). SMA and S-100 protein positive rate were 14.3%(3/21) and 4.7%(1/21).2. The efficacy and safety of postoperative adjuvant therapy with imatinib mesylate:CR rate is 86.7%(26/30); PD rate is 13.3%(4/30); the patients who progress took IM 600mg/d, and then 3 cases get SD, the patients who still progress took sunitinib. The total effective is 86.7%; The total benefit rate is 96.7%. The toxicities of imatinib mesylate are very mild. The main toxicities see the table 1 Table 1 The main toxicities of imatinib mesylate. Adverse reactions Degre Cases Percentage(%) Edema Mild 20 76.9 Leukopenia Mild and Moderate 10 38.5 Diarrhea Mild 8 30.8 Abdominal pain Mild 4 15.4 Fatigue Mild 5 19.2 Nausea and vomiting Mild and Moderate 2 7.7 Efflorescence Mild 1 3.8Conclusion:1. GIST specific expresses KIT protein (CD 117). and the positive rate of CD 117 is very high. CD117 is the main immunohistochemical indicator of diagnosis of GIST.2. As an inhibitor of tyrosine kinase, imatinib mesylate is generally well tolerated and has been proved to be effective and safe during prolonged treatment of patients with gastrointestinal stromal tumor patients with high risk of recurrence.