Treatment
Historical perspective
Before the availability of Glivec, the only treatments for GIST other than surgery were conventional chemotherapy and radiation therapy.1,2 The role of chemotherapy and radiation therapy has been limited by a lack of efficacy and intolerable toxicity. Clinical trial data show that response rates to any cytotoxic chemotherapy regimen range from approximately 0 to 5%.2,3 Other evidence confirms that conventional chemotherapy does not have a role in the management of patients with GIST.
Radiation therapy is limited by its toxicity to surrounding structures, especially the intestine, and is therefore of limited value.2,4
References:
1. Eisenberg BL, Judson I. Surgery and imatinib in the management of GIST: emerging approaches to adjuvant and neoadjuvant therapy. Ann Surg Oncol. 2004;11:464-475.
2. Dematteo RP, Heinrich MC, El-Rifai WM, Demetri G. Clinical management of gastrointestinal stromal tumors: before and after STI-571. Hum Pathol. 2002;33:466-477.
3. Demetri G, Benjamin R, Blanke CD, et al. NCCN Task Force Report: optimal management of patients with gastrointestinal stromal tumor (GIST)--expansion and update of NCCN Clinical Practice Guidelines. J Natl Compr Canc Netw. 2004;2(suppl 1):S1-S26
4. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51-58.