علاج الورم اللحمي المعدي المعوي في المرحلة المتقدمة محلياً

References

DOI: 10.1177/17588359231192388

• A treatment strategy based on front-line imatinib followed by surgery can be occasionally indicated in GIST patients with locally advanced disease.
• Treatment with neoadjuvant imatinib can be considered in a multidisciplinary tumor board in GIST patients with locally advanced disease in which tumor shrinkage can facilitate the surgical procedure (III,A).
• However, it is estimated that surgery could be performed between 6 and 12 months after initiation of imatinib, as maximal response and minimal risk of secondary resistance are expected in this time interval.
• Imatinib can be stopped 24 h before the surgery and reinitiated once the oral tolerance has been confirmed.
• Early response assessment, that is, after 4 weeks of treatment initiation is highly recommended since an unsuccessful imatinib treatment could impede a surgical procedure that otherwise could have been undertaken.