Treatment of metastatic, imatinib refractory, gastrointestinal stroma tumor with image-guided high-dose-rate interstitial brachytherapy

Omari, Jazan; Drewes, Ralph; Manig, Matthias; Mohnike, Konrad; Seidensticker, Max; Seidensticker, Ricarda; Streitparth, Tina; Ricke, Jens; Powerski, Maciej; Pech, Maciej

doi:10.1016/j.brachy.2018.09.006

Cited by 7 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, some patients might have been contaminated by TKIs after surgery, which was not reported. Meanwhile, previous studies have indicated that surgery should be chosen with greater caution in patients with multiple systemic metastases [48]. In cases of limited disease progression after TKIs, a more aggressive approach can be chosen [74,75], but the risks of surgical complications and potential benefits cannot be quantified [76,77].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there were three other case series, which did not clearly describe the specific scenarios of radiotherapy combined with TKIs [47][48][49]. Joensuu et al reported 25 patients with advanced or metastatic GISTs receiving radiotherapy, which was a prospective clinical study [47].…”

Section: Resistant To 2 Tkismentioning

confidence: 99%

“…Both interstitial brachytherapy (iBT) and radioembolization are internal irradiation. Omari et al reported that among 10 imatinib-resistant metastatic GISTs treated with iBT (TKIs continued in 7 patients), 1 recurred, and 6 died during follow-up (range, 2.3-92.9 months), with a median PFS of 6.8 months (range, 3.0-20.2) and a median OS of 37.3 months (range, 11.4-89.7); local tumor control was 97.5% [48]. Rathmann et al reported nine patients who received radioembolization for liver metastases [49].…”

Section: Resistant To 2 Tkismentioning

confidence: 99%

“…There were five case reports and four case series reporting adverse events [11,20,22,25,[47][48][49]52,54]. Adverse reactions were reported in 14 patients from 5 case reports and 1 case series with nausea in 3 patients (grade 1), diarrhea in 3 (grade 1-3), fatigue in 3 (grade 1-2), esophagitis in 2 (grade 2), proctitis in 1 (grade 2), chest pain in 1 (grade 1), urinary urgency in 1 (grade 1), dysgeusia in 1 (grade 1), mucositis in 1 (grade 2), dermatitis in 2 (grade 1), and moist desquamation in 1 (grade 2) [11,20,22,25,52,54].…”

Section: Adverse Eventsmentioning

confidence: 99%

“…Only one patient developed grade 4 biliary tract necrosis [47]. Omari et al reported that of 10 patients with imatinib-resistant metastatic GISTs who received iBT, 3 had elevated inflammatory parameters (grade 1), and 2 had local hepatic hemorrhage and pneumothorax (grade 3) [48].…”

Section: Adverse Eventsmentioning

confidence: 99%

See 4 more Smart Citations

Radiotherapy in the Management of Gastrointestinal Stromal Tumors: A Systematic Review

Zhang

Jiang

et al. 2022

Cancers

View full text Add to dashboard Cite

Gastrointestinal stromal tumors (GISTs) are considered insensitive to radiotherapy. However, a growing number of case reports and case series have shown that some lesions treated by radiotherapy achieved an objective response. The aim of the study was to perform a systematic review of all reported cases, case series, and clinical studies of GISTs treated with radiotherapy to reevaluate the role of radiotherapy in GISTs. A systematic search of the English-written literature was conducted using PubMed, Web of Science, and Embase databases. Overall, 41 articles describing 112 patients were retrieved. The included articles were of low to moderate quality. Bone was the most common site treated by radiotherapy, followed by the abdomen. In order to exclude the influence of effective tyrosine kinase inhibitors (TKIs), a subgroup analysis was conducted on whether and which TKIs were concurrently applied with radiotherapy. Results showed that radiotherapy alone or combined with resistant TKIs could help achieve objective response in selected patients with advanced or metastatic GISTs; however, survival benefits were not observed in the included studies. Pain was the most common symptom in symptomatic GISTs, followed by neurological dysfunction and bleeding. The symptom palliation rate was 78.6% after excluding the influence of effective TKIs. The adverse reactions were mainly graded 1–2. Radiotherapy was generally well-tolerated. Overall, radiotherapy may relieve symptoms for GIST patients with advanced or metastatic lesions and even help achieve objective response in selected patients without significantly reducing the quality of life. In addition to bone metastases, fixed abdominal lesions may be treated by radiotherapy. Publication bias and insufficient quality of included studies were the main limitations in this review. Further clinical studies are needed and justified.

show abstract