Điều trị tăng liều imatinib trên bệnh nhân u mô đệm đường tiêu hoá giai đoạn muộn tiến triển sau điều trị bước 1 liều chuẩn

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Tác giả: Do Hung Kien, Thi Bich Phuong Nguyen, Van Tai Nguyen, Thi Thu Vu

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Journal of Clinical Medicine – Hue Central Hospital, 2020

Mô tả vật lý: tr.39-43

Bộ sưu tập: Metadata

ID: 379319

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Đánh giá kết quả điều trị tăng liều Imatinib trên bệnh nhân u mô đệm đường tiêu hóa giai đoạn muộn tiến triển sau điều trị bước 1 liều chuẩn. Phương pháp nghiên cứu: Hồi cứu kết hợp tiến cứu 46 bệnh nhân (BN) u mô đệm đường tiêu hoá giai đoạn muộn được chẩn đoán và điều trị Imatinib tăng liều tại bệnh viện K từ 1/2015 đến 10/2019. Kết quả: Tuổi mắc bệnh trung bình là 54,6±9,5, chủ yếu là nam giới, chiếm 58,7%. Đa phần BN có vị trí u nguyên phát ban đầu tại dạ dày, chiếm 60,8%. Thời gian trung bình điều trị Imatinib 400mg/ngày là 38,2±5,3 tháng. Gan là vị trí tổn thương tiến triển hay gặp nhất chiếm 71,7%, tổn thương u nguyên phát tiến triển gặp 39,1%. Không có BN nào đạt đáp ứng hoàn toàn
tỷ kệ đáp ứng đạt 21,7%, bệnh giữ nguyên chiếm tỷ lệ 45,7%. Tỷ lệ kiểm soát bệnh của thuốc đạt 67,4%. Tỷ lệ đáp ứng cao hơn ở nhóm bệnh nhân nữ giới, u nguyên phát dạ dày, chỉ số toàn trạng tốt, chỉ số giới hạn bình thường của bạch cầu hạt, huyết sắc tố và albumin trước điều trị so với các nhóm đối chứng. Thời gian điều trị imatinib liều cao trung bình là: 22,5 ± 3,4 (tháng), (min: 2,0
max: 58,0), trung vị là 11,0 tháng. Kết luận: Điều trị Imatinib tăng liều sau tiến triển bước 1 liều chuẩn đem lại kết quả và dung nạp thuốc chấp nhận đượcObjective: Evaluating the result of high-dose imatinib for metastatic gastrointestinal stromal tumoursafter failure standard-dose first line.Patients and method: Restrospective analysis of 46 patients with metastatic gastrointestinal stromaltumours after failure standard-dose imatinib treated with high-dose imatinib at K hospital from 1/2015 đến10/2019. Results: Median age was 54.6±9.5, male was 58.7%. The common primary tumor was gastric tumor.The mean time to failure of imatinib standard-dose 400mg/day was 38.2±5.3 months. Liver lesions were themost common lesions progressed after imatinib standard-dose failure (71.7%), primary tumor progressedwas 39.1%. There was no patient who had complete response with treatment, the proportion of partialresponse accounted for 21.7% and stable disease was 45.7%. The clinical benefit rate was 67.4%. Thesex-female, primary gastric tumor, good ECOG performance status, neutrophils, hemoglobine and albuminbefore treatment were the significant prognostic factors affecting the treatment response, p <
0.05. Themean time to failure was 22.5 ± 3.4 (months), (min: 2.0
max: 58.0), median was 11.0 months.Conclusion: Treatment of high-dose imatinib after failure standard-dose 400mg/day showed the ef- ficacy and good tolerance in metastatic GISTs.

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