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目的了解甲磺酸伊马替尼治疗胃肠道间质瘤(GIST)后皮肤不良反应发生情况。方法选择2008年6月-2015年6月期间服用甲磺酸伊马替尼治疗的184例胃肠道间质瘤患者进行随访,包括患者的一般情况、间质瘤发病状况、治疗中的不良反应等。结果 184例患者中,发生皮肤不良反应66例(35.87%),其中严重皮肤不良反应6例(9.09%),6例患者中有4例予停止甲磺酸伊马替尼治疗,改为苏尼替尼治疗后皮损好转,但最终有2例因肝脏、腹腔转移分别于24个月、29个月后死亡,2例因复发胃、直肠间质瘤于18个月、26个月后死亡;另2例暂停甲磺酸伊马替尼7~10d后减量继续原法治疗,并加用糖皮质激素后皮损好转,继续用甲磺酸伊马替尼治疗中。结论甲磺酸伊马替尼治疗胃肠道间质瘤所发生的皮肤不良反应大多属于免疫介导的药物反应,轻中型病例无须特殊处理,重型病例可采用短暂停药、减量服药并加用糖皮质激素的方法进行治疗,采用苏尼替尼替代治疗对胃肠道间质瘤的疗效不佳。
Objective To understand the adverse reactions of skin after gastrointestinal stromal tumors (GIST) treated with imatinib mesylate. Methods A total of 184 patients with gastrointestinal stromal tumors treated with imatinib mesylate during June 2008-June 2015 were followed up, including the general condition of the patients, the incidence of stromal tumors, and the treatment failure Reaction and so on. Results Among the 184 patients, 66 cases (35.87%) had skin adverse reactions, of which 6 cases (9.09%) had severe skin adverse reactions. Of the 6 patients, 4 cases stopped using imatinib mesylate instead of After the treatment of nimotin, the skin lesions improved, but in the end 2 patients died of liver and abdominal metastases at 24 months and 29 months respectively. Two patients died of recurrence of stomach and rectum stromal tumors at 18 months and 26 months Died; the other two cases of suspension of imatinib mesylate 7 ~ 10d after the reduction to continue the original treatment, and add glucocorticoid lesions improved, continue to use imatinib mesylate treatment. Conclusion The adverse reactions of imatinib mesylate in the treatment of gastrointestinal stromal tumors are mostly immune-mediated drug reactions, light and medium-sized cases without special treatment, heavy-duty cases can be short-term withdrawal, reducing dosage and plus Treatment with glucocorticoid method, the use of sunitinib replacement therapy on gastrointestinal stromal tumors poor efficacy.