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.

Recently, endoplasmic reticulum (ER) stress has been shown to influence tumor progression and immune cell function in the tumor microenvironment (TME). However, the underlying role of ER stress-related gene patterns in colorectal cancer (CRC) development remains unclear. We analyzed the ER stress-related gene patterns in 884 patients with CRC from the Gene Expression Omnibus database and evaluated the cell-infiltrating patterns in the TME. Two ER stress-related patterns were identified in patients with CRC that had distinct cell-infiltrating patterns in the TME and clinical characteristics. A risk score and nomogram based on 14 screened prognosis-correlated genes was built and validated to predict patient survival. Patients with a higher risk score were shown to have an unfavorable prognosis, and the risk score was associated with cell infiltration and drug sensitivity. Furthermore, spatial transcriptomics data were utilized to explore ER stress-related gene patterns in CRC tissues, and it was shown that ER stress phenotype involves in the formation of the immunosuppressive TME. This study demonstrated that ER stress-related gene patterns play a role in influencing the TME and predicting prognosis. These analyses of ER stress in the TME of CRC might deepen our understanding of CRC progression and immune escape and provide novel insights into therapeutic strategies.

The concurrent presence of gastrointestinal stromal tumor and schwannoma is extremely rare, and its pathological characteristics remain unclear. This case report reported the diagnostic and treatment process of a patient with a pancreatic GIST coexisting with esophageal schwannoma, who was admitted to West China Hospital (Sichuan, China) in April 2015. The patient did not undergo surgical resection of the tumor but instead received an 8-year regimen of imatinib therapy, during which no tumor progression was observed. However, the patient developed pleural effusion as a result of the localized enlargement of the esophageal schwannoma, which exerted pressure on the right inferior pulmonary vein. This case report provides valuable clinical insights into this distinctive disease presentation.

The underlying mechanism of malignant progression in gastrointestinal stromal tumors (GISTs) is not fully understood. Despite recent advancements, a comprehensive profile of metabolome, transcriptome, and proteome of GISTs is lacking. This study conducted an integrated multi-omics analysis of GISTs across different risk classifications. By integrating metabolomics, transcriptomics, and proteomics, we identify distinct metabolic patterns and associated biological pathways implicated in the malignant progression of GISTs. Moreover, we identified galactose metabolism and the pivotal rate-limiting enzyme AKR1B1 is dysregulated in GISTs progression. AKR1B1 was upregulated and predicted poor prognosis in GISTs. In addition, AKR1B1 knockdown resulted in trehalose accumulation in GIST cells, thereby inhibiting cell proliferation and mitosis. These findings not only enhance our comprehension of the underlying mechanisms governing GIST progression from a metabolic reprogramming standpoint but also furnish prognostic biomarkers and potential therapeutic targets for GISTs.

Neurofibromatosis type 1 (NF1), an autosomal dominant disorder resulting from mutations in the NF1 tumor suppressor gene, predisposes affected individuals to diverse benign and malignant neoplasms. We herein report a rare case of a 61-year-old female NF1 patient presenting with a unique combination of four synchronous or metachronous tumors: a duodenal ampullary neuroendocrine tumor (NET, Grade 2), a high-risk gastrointestinal stromal tumor (GIST) of the small intestine, a previously resected gastric leiomyoma, and cutaneous neurofibromas. Preoperative evaluation included endoscopy, endoscopic ultrasound, contrast-enhanced CT, and MRI, which localized the lesions and assessed their morphological features. The patient underwent pancreaticoduodenectomy and partial small bowel resection, achieving complete tumor resection. Genetic testing identified a germline NF1 mutation (p.Y2182*). No adjuvant therapy was administered due to the absence of residual disease and actionable mutations. This case highlights the broad tumor spectrum in NF1 and underscores the importance of comprehensive imaging, multidisciplinary management, and genetic testing for optimal outcomes.