Журнал «Практическая онкология» Том 7, №1, 2024

Гастроінтестинальні стромальні пухлини (GIST) — рідкісні злоякісні новоутворення шлунково-кишкового тракту, однак є найпоширенішим варіантом серед сарком. Більшість таких пухлин діагностується у шлунку (80 %), до 20 % припадає на тонку кишку. Лікування пацієнтів з гастроінтестинальними стромальними пухлинами зазнало значних змін з появою інгібіторів тирозинкінази, які пригнічують тирозинкінази c-KIT та рецептор тромбоцитарного фактора росту альфа. Цей огляд охоплює аспекти ведення пацієнтів з гастроінтестинальними стромальними пухлинами, а саме користь неоад’ювантної та ад’ювантної системної терапії для пацієнтів з такими пухлинами, а також особливості виконання хірургічних втручань у пацієнтів з метастатичними ураженнями та без них. Поліпшилась терапія хворих з поширеними та метастатичними GIST завдяки застосуванню нових тирозинкіназних інгібіторів і хворих з визначеними драйверними мутаціями при «дикому» типі GIST. Чітко визначене поняття іматиніб-нечутливих GIST. Завдяки комплексному підходу до лікування можливе поліпшення прогнозу захворювання та досягнення тривалої ремісії у пацієнтів з метастатичним перебігом.

Gastrointestinal stromal tumors (GISTs) are rare malignant neoplasms of the gastrointestinal tract, but they are the most common type of sarcoma. Most of these tumors are diagnosed in the stomach (80 %), with up to 20 % occurring in the small intestine. The treatment of patients with gastrointestinal stromal tumors has undergone significant changes with the emergence of tyrosine kinase inhibitors, which, in turn, inhibit the c-KIT tyrosine kinases and platelet-derived growth factor receptor alpha. This review covers aspects of managing patients with gastrointestinal stromal tumors, namely the benefits of neoadjuvant and adjuvant systemic therapy for patients with such tumors, as well as the peculiarities of performing surgical interventions in patients with and without metastatic involvement. The therapy of patients with advanced and metastatic GISTs has improved due to the use of new tyrosine kinase inhibitors, as well as the treatment of individuals with driver mutations in wild-type GISTs. The concept of imatinib-insensitive GISTs is clearly defined. Due to an integrated approach to treatment, it is possible to improve the prognosis of the disease and achieve long-term remission in patients with metastases.

гастроінтестинальні стромальні пухлини; хіміотерапія; хірургічне лікування; метастатичний перебіг

gastrointestinal stromal tumors; chemotherapy; surgical treatment; metastasis

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