Response evaluation of gastrointestinal stromal tumors
Response evaluation of gastrointestinal stromal tumors
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DOI：
10.1634/theoncologist.13-s2-4
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发表时间：
2008-01-01
期刊：
影响因子：
5.8
通讯作者：
Choi, Haesun
中科院分区：
文献类型：
--
作者：
Choi, Haesun
胃肠道间质瘤（gist）患者的临床管理随着新疗法（如甲磺酸伊马替尼）的引入发生了巨大变化。这就需要重新评估用于评估治疗反应的现有标准。目前的实体瘤应答评价标准是基于肿瘤的单维大小，并没有考虑到胃肠道间质瘤的应答变化，如肿瘤密度的减少和瘤内血管数量的减少（CT）。研究发现，正电子发射断层扫描（PET）在检测早期反应方面具有高度敏感性，并可用于预测转移性GIST患者对伊马替尼的长期反应；然而，由于缺乏扫描仪可用性和成本限制，PET的广泛使用受到限制。结合肿瘤密度和肿瘤大小的改进CT标准在早期反应评估中有希望，并具有良好的预后价值。确定适当的治疗反应标准对于优化GIST患者的治疗至关重要。
Clinical management of patients with gastrointestinal stromal tumors (GISTs) has dramatically changed with the introduction of novel therapeutics, such as imatinib mesylate. This has created a need to re-evaluate the existing criteria used to assess treatment response. The current Response Evaluation Criteria in Solid Tumors are based on unidimensional tumor size, and do not take into account changes in responding GISTs such as a decrease in tumor density and decrease in the number of intratumoral vessels with computed tomography (CT). Positron emission tomography (PET) has been found to be highly sensitive in detecting early response, and to be useful in predicting long-term response to imatinib in patients with metastatic GIST; however, widespread use of PET is limited because of a lack of scanner availability and cost constraints. Modified CT criteria using a combination of tumor density and tumor size are promising in early response evaluation, and have excellent prognostic value. Identifying appropriate treatment response criteria is essential to optimize treatment for patients with GIST.