手术联合伊马替尼与单纯伊马替尼治疗复发或转移胃肠道间质瘤的疗效比较.docVIP

  Combined Operation Modality vs. Imatinib Mesylate Alone for Patients with Recurrent or Metastatic Gastrointestinal  5 10 15 20 25 30 35 Stromal Tumors: the Randomized COMVIA Trial DU Chunyan1, ZHOU Ye1, SONG Chun2, WANG Yongpeng2, JIE Zhigang3, LIANG Xiaobo4, HE Yulong5, CAO Hui6, YAN Zhongshu7, SHI Yingqiang1** (1. Department of Gastric Cancer and Soft Tissue Surgery, Cancer Center, Fudan University, ShangHai 200237; 2. Department of Colorectal Surgery, Liaoning Cancer Hospital Institute, ShenYang 110042; 3. Department of General Surgery, the First Affiliated Hospital of Nanchang University, NanChang 300006; 4. Department of Colorectal Cancer, Shanxi Cancer Hospital, TaiYuan 030013; 5. Department of Gastrointestinal Panceatic Surgery, the First Affiliated Hospital, Sun Yat-sen University, GuangZhou 510080; 6. Department of General Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, ShangHai 200127; 7. Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, ChangSha 410008) Abstract: Objectives:Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. For advanced GIST patients who are responding to imatinib mesylate, the role of surgery has not been formally demonstrated. Therefore, this multicenter, randomized, controlled trial was designed to assess whether surgeries to treat residual disease for patients with recurrent/metastatic GISTs responding to imatinib mesylate (IM) improves progression free survival (PFS) compared with IM treatment alone. Methods: Between 3 and 12 months after starting molecular-targeted therapy with IM for recurrent/metastatic GISTs, eligible patients were randomized to two arms: Arm A (surgery for residual disease) and Arm B (IM treatment alone). In Arm A (19 pts), surgery was performed to remove residual macroscopic lesions as completely as possible, and IM treatment continued after surgery. In Arm B (22 pts), IM was given alo