作者：石一航，张信华

单位：中山大学附属第一医院 胃肠外科中心， 广东 广州 510080

Authors: Shi Yihang，Zhang Xinhua

Unit: Department of Gastrointestinal Surgery，the First Affiliated Hospital of Sun Yat-sen University，Guangzhou 510080，Guangdong，China

摘要：

胃肠间质瘤是最常见的消化道间叶源性肿瘤。胃肠间质瘤对放疗和化疗不敏感，外科手术是目前治疗原发局限性胃肠间质瘤的首选治疗方式。在没有辅助治疗的情况下，超过40%的患者在完整切除术后会出现复发或者转移。伊马替尼将胃肠间质瘤的治疗从单一手术切除转变为手术与靶向治疗相结合的模式。伊马替尼最初被应用在晚期患者的治疗中，并取得了显著疗效。ACOSOG Z9000、ACOSOG Z9001、EORTC-62024等临床试验结果证明了伊马替尼也可显著改善中高危原发局限性胃肠间质瘤患者的预后，提高无复发生存率和总生存率。笔者以胃肠间质瘤的术后辅助治疗为主题，总结辅助治疗在胃肠间质瘤中的历程及现状，探讨目前伊马替尼在胃肠间质瘤辅助治疗中应用的现状及挑战。

关键词：胃肠间质瘤； 辅助治疗； 伊马替尼； 无复发生存率； 总生存率

Abstract：

Gastrointestinal stromal tumor（GIST）is the most common gastrointestinal mesenchymal tumor. GIST is not sensitive to radiotherapy and chemotherapy. Surgery is currently the preferred treatment for primary localized GIST，but more than 40% of patients experience recurrence and metastasis after resection. Imatinib shifts the treatment for GIST from a single surgical resection to a combination of surgery and targeted therapy. Imatinib was initially used in the treatment of patients with advanced GIST and achieved significant efficacy. In the field of postoperative adjuvant therapy，the results of clinical trials such as ACOSOG Z9000，ACOSOG Z9001，and EORTC -62024 have proved that imatinib can significantly improve the prognosis of patients with intermediate and high -risk primary localized GIST，and improve the recurrence -free survival and overall survival. The authors focus on postoperative adjuvant therapy of GIST ，summarize the history and current situation of adjuvant therapy in GIST，and discuss the status and challenges of imatinib in adjuvant therapy for GIST.

Key Words:  Gastrointestinal stromal tumor ; Adjuvant therapy ; Imatinib ; Recurrence -free survival; Overall survival