索拉非尼治疗晚期肾癌的临床观察

摘要

Objective To evaluate the efficacy and safety of sorafenib in the treatment of advanced renal cell carcinoma.Methods The clinical date of 33 patients with advanced renal cell carcinoma from September 2007 to April 2012 was reviewed retrospectively.26 were males and 7 were females,with an average age of 69 years.Pathological diagnosis showed 30 clear cell RCCs,2 papillary RCCs,and 1 unclassified RCC.These patients were treated by sorafenib 400 mg twice a day until intolerable toxicity or disease progression.The primary end points were objective response rate,clinical benefit rate,median survival time,median progression-free survival and the incidence of adverse reaction.Results All patients were evaluable for response and toxicity,with 8 patients (24％) of partial remission,19 cases (58％) of stable disease,and 6 cases (18％) of disease progression.The disease control rate was 82％,the median progression-free survival was 10.2 months,while the median survival time was 16.5 months.The common adverse reactions included hand-foot skin reaction (61％),diarrhea (46％),hypertension (21％).Most adverse reactions occurred around the second week after drug therapy,with the duration unequal.The majority of adverse reactions could be released by symptomatic treatment,which did not affect the medication.Conclusion Sorafenib has good short term efficacy for patients with advanced renal cell carcinoma,and most adverse reactions were tolerable.%目的 分析和评价索拉非尼治疗晚期肾癌的疗效和安全性. 方法 回顾性分析2007年9月至2012年4月我院诊断明确的晚期肾细胞癌患者33例,男26例,女7例.年龄32～83岁,中位年龄69岁.其中透明细胞癌30例,乳头状细胞癌2例,未分化癌l例.采用口服索拉非尼400 mg,2次/d,单药治疗,持续治疗至肿瘤进展或出现不可耐受的不良反应.主要观察终点为客观有效率、临床获益率、中位生存时间、中位无疾病进展时间和不良反应发生率. 结果 可评价疗效患者33例.其中部分缓解8例(24％),疾病稳定19例(58％),疾病进展6例(18％),疾病控制率82％,中位生存时间16.5个月,中位无疾病进展时间10.2个月.1年生存率67％.常见不良反应包括手足皮肤病变20例(61％)、腹泻15例(46％)、高血压7例(21％).多数不良反应于服药2周左右出现,持续时间不等,经对症治疗后缓解,未影响服药. 结论 索拉非尼治疗晚期肾癌的疗效良好,大部分不良反应患者可耐受.