实用肿瘤杂志2025，Vol.40Issue(5)：422-432,11.DOI:10.13267/j.cnki.syzlzz.2025.062
局部晚期胃肠间质瘤新辅助治疗疗效及其影响因素的多中心回顾性研究
Multicenter retrospective study on efficacy of neoadjuvant therapy for locally advanced gastrointestinal stromal tumors and its influencing factors
摘要
Abstract
Objective To investigate the efficacy of neoadjuvant therapy in patients with locally advanced gastrointestinal stromal tumors(GISTs)and its influencing factors in real-world settings.Methods Patients with locally advanced GISTs who received neoadjuvant ther-apy between April 1st,2014,and April 1st,2025,across 16 hospitals,including Jiangsu Provincial People's Hospital,Nanjing Drum Tower Hospital,Jiangsu Cancer Hospital,Affiliated Hospital of Xuzhou Medical University,Northern Jiangsu People's Hospital,Lianyungang Second People's Hospital,the First Affiliated Hospital of Soochow University,Nanjing First Hospital,Yancheng No.1 People's Hospital,Wuxi People's Hospital,the First People's Hospital of Changzhou,Affiliated Hospital of Nantong University,the First People's Hospital of Nantong,Affiliated Hospital of Yangzhou University,the Second People's Hospital of Changzhou,and Wuxi Second People's Hospital,were retrospectively enrolled.O bjective response rate(ORR)was evaluated using Response Evaluation Criteria in Solid Tumors(RECIST)1.1.The associations of objective response and prognosis with demographic features,clinicopathological characteristics,and genetic muta-tions were analyzed.Statistical methods included univariate analysis,multivariate logistic and Cox regression,and Kaplan-Meier analysis.Results Among 137 initially collected GIST patients,104 cases treated with imatinib and with complete data were analyzed.The ORR was 43.3%,mean tumor reduction rate was 26.96%,and R0 resection rate was 97.7%.Univariate analysis showed lower ORR in patients with mitotic figures≥5/50 HPF(P=0.029)and a trend toward lower ORR in those with KIT proto-oncogene,receptor tyrosine kinase(KIT)exon 11 deletion mutations(P=0.075).Multivariate logistic regression confirmed that both factors were independently associated with reduced ORR(both P<0.05).Univariate Cox regression indicated that mitotic figures<5/50 HPF reduced postoperative recurrence risk(P=0.018),but multivariate Cox regression found no significant prognostic factors for disease-free survival(all P>0.05).Conclusions Neoadjuvant imatinib effectively reduces tumor volume and achieves high R0 resection rate in locally advanced GISTs.KIT exon 11 deletion mutations and high mitotic activity(≥5/50 HPF)are potential predictors of suboptimal ORR,with the latter correlating with poorer long-term out-comes.For patients with inadequate tumor reduction,alternative strategies to enhance neoadjuvant efficacy are urgently needed.关键词
胃肠间质瘤/新辅助治疗/伊马替尼/客观缓解率Key words
gastrointestinal stromal tumor/neoadjuvant therapy/imatinib/objective response rate引用本文复制引用
钱磊,周林森,沈伟,吴骏,支小飞,冯士春,倪庆,蒋华,夏加增,李沣员,徐泽宽,张强,徐皓,王峰,孙小峰,宋虎,石磊,苗永昌,周晓俊,吕成余..局部晚期胃肠间质瘤新辅助治疗疗效及其影响因素的多中心回顾性研究[J].实用肿瘤杂志,2025,40(5):422-432,11.基金项目
江苏省医学重点学科(普通外科学)(ZDXKA2016005) （普通外科学）
江苏省重点研发计划(BE2016786) （BE2016786）
江苏高校优势学科建设工程资助项目(IX10231801) （IX10231801）
国家自然科学基金面上项目(82373335) （82373335）
江苏省科教能力提升工程(江苏省医学重点学科)(ZDXK202222) （江苏省医学重点学科）
江苏省人民医院临床研究专病项目(DL202413) （DL202413）
