摘要
目的探讨间变性淋巴瘤激酶-酪氨酸激酶抑制剂(ALK-TKI)治疗炎性肌纤维母细胞瘤(IMT)的效果。方法回顾性分析武汉大学人民医院2018年收治的1例复发腹腔IMT患者的临床病理资料,并系统回顾2010年1月至2020年8月文献报道的41例IMT患者的临床病理及分子特征、ALK-TKI治疗效果及预后。结果武汉大学人民医院收治的腹腔IMT患者为27岁女性,术后2个月复发,化疗联合贝伐珠单抗治疗无效;口服克唑替尼1个月后病情缓解,29个月后达完全缓解(CR)。文献报道的41例IMT患者中位发病年龄22岁(0~61岁),32例(78.0%)多器官受累,均复发或转移。ALK突变38例,TFG-ROS1融合基因阳性3例;ALK-TKI一线治疗中34例应用克唑替尼,中位耐药时间8个月(2~48个月)。ALK-TKI总临床获益率为85.3%(29/34),20例CR,中位首次CR时间11个月(4~36个月),CR患者中位用药时间19.5个月(2~60个月)。初治行手术和(或)放化疗的24例患者中位无进展生存(PFS)时间为4个月(1~45个月);进展后均行ALK-TKI治疗,中位PFS时间为14个月(3~62个月)。结论IMT是具有复发转移特性的真性肿瘤,ALK-TKI与手术、放化疗合理联用可改善IMT患者预后。
Objective To investigate the efficacy of anaplastic lymphoma kinase-tyrosine kinase inhibitors(ALK-TKI)in treatment of inflammatory myofibroblastic tumor(IMT).Methods The clinicopathological data of one recurrent abdominal IMT patient in Renmin Hospital of Wuhan University in 2018 were retrospectively analyzed.The clinicopathological and molecular characteristics,ALK-TKI treatment efficacy and prognosis of 41 patients with IMT reported in the literature from January 2010 to August 2020 were systematically reviewed.Results This patient with abdominal IMT in Renmin Hospital of Wuhan University was a 27-year-old female who relapsed 2 months after surgery.Chemotherapy combined with bevacizumab was ineffective.After oral administration of crizotinib,the condition resolved after 1 month,and complete remission(CR)was achieved after 29 months.The median age of onset of 41 IMT cases reported in the literature was 22 years old(0-61 years old),of which 32 cases(78.0%)had multiple organ involvement,all of which had recurrence or metastasis.There were 38 cases of ALK mutation and 3 cases of TFG-ROS1 fusion gene-positive.Thirty-four patients treated with crizotinib in the first-line treatment of ALK-TKI,and the median resistance time of crizotinib was 8 months(2-48 months).The total clinical benefit rate of ALK-TKI was 85.3%(29/34),and 20 patients achieved CR.The median time for the first CR was 11 months(4-36 months),and the median duration time of medication for CR patients was 19.5 months(2-60 months).The median progression-free survival(PFS)time of 24 patients who underwent surgery and/or chemotherapy and radiotherapy was 4 months(1-45 months);after progression,ALK-TKI treatment was performed,and the median PFS time was 14 months(3-62 months).Conclusions IMT is a true neoplasm with characteristics of recurrence and metastasis.Reasonable combination of ALK-TKI with surgery,radiotherapy and chemotherapy can improve the prognosis of IMT patients.
作者
陈佳梅
罗波
罗茜茜
王琼
石薇
蔡高科
赵文思
成浩
陈永顺
Chen Jiamei;Luo Bo;Luo Xixi;Wang Qiong;Shi Wei;Cai Gaoke;Zhao Wensi;Cheng Hao;Chen Yongshun(Center of Oncology,Renmin Hospital of Wuhan University,the First Clinical College of Wuhan University,Wuhan 430060,China;Department of Pathology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China;Department of Pathology,Central Theater General Hospital of Chinese PLA,Wuhan 430070,China)
出处
《肿瘤研究与临床》
CAS
2021年第8期585-590,共6页
Cancer Research and Clinic
基金
国家自然科学基金(81901820/H18)
湖北省卫生健康科研基金(WJ2019H365)。
