常规及加量剂量的索拉非尼治疗转移性肾癌17例疗效观察

摘要

目的：探讨抑制血管生成的分子靶向药物酪氨酸激酶抑制剂索拉菲尼常规剂量及加量后治疗晚期肾透明细胞癌的疗效。方法：我科从2007年3月~2011年11月接受索拉菲尼治疗的17例晚期肾癌患者(mRCC),观察常规剂量治疗转移性肾癌的疗效,及常规剂量多吉美治疗第一次进展的病人,加量至600mg,bid应用后患者的无疾病进展时间,再次进展后再次加量至800mg,bid后的无疾病进展时间,并观察其不良反应。结果：该组患者常规剂量多吉美治疗的中位疾病进展时间(TTP)10个月,加量至600mg,bid后中位疾病进展时间(TTP)为10个月,中位生存期25个月。结论：索拉菲尼对转移性肾癌具有明显的治疗效果,常规剂量进展的病人,加量应用后大部分患者仍获得较长的无疾病进展时间,提示加量治疗后可能仍有效,且安全性较高。%　　Objective:To investigate the respective Therapeutic efficacy that the standard doses of and increased doses of sorafenib, a molecular targeted therapeutic drug inhibiting angiogenesis and also a tyrosine kinase inhibitor, may have for the treatment of advanced renal clear cel carcinoma.Method:Observingthecurativeefficacy,progression-freesurvivaltimeandsideeffectsthatsorafenibhaveonrespectively:(1)groupofpatientstakingstandarddoses ofsorafenibinsorafenibtreatmentphase-one;(2)groupofpatientstaking600mg,bid;and(3)groupofpatientstaking800mg,bid.Thepatientsareselected from17caseswhohavesuf eredfromtheadvancedrenalcel carcinoma(mRCC)andhavereceivedsorafenibtreatmentinourdepartmentfromMarch,2007 toNovember,2011.Results:Thegroupofpatientstakingstandarddosesofsorafenibhasa10-monthmediantimetoprogressionphase(TTP).Thegroupof patientstaking600mg,bidofsorafenibhasa10-monthmediantimetoprogressionphase(TTP).Themediansurvivaltimeis25months.Conclusion:Sorafenib has obvious therapeutic effect for metastatic kidney cancer.Patients taking standard doses,after taking increased doses,could stil have a relatively long progression-free survival period. It suggests that increased doses might be effective as wel and improves the safety.